[2018-2019] Emergency Medicine Rank Order List Thread

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Applicant Summary
Board scores: 240s/250s
EM rotation grades: Pass (P/F only)/Pass/High Pass
AOA: No
Medical school region: East coast
Anything that made you more competitive: MBA completed on full-ride scholarship during medical school; seven publications/posters/presentations, all in EM.

***Interesting life-story: diagnosed with cancer at the start of the 1st year of medical school, underwent treatment during medical school without taking leave; programs seemed very interested in this and I think it demonstrates grit which is important in this specialty. Significant and extensive State and National leadership with one of the big 3 EM organizations. I was informed by a Program Director I personally know through work with one of the Big 3 EM organizations that I had two bottom 1/3 SLOEs and one middle 1/3 SLOE. I recognize this does not make me *more* competitive but I just want to put it out there as it likely had an impact on my opportunities during the interview season.***

Main considerations in creating this ROL: Training & Quality of Life (Location, dating pool, well-serviced airport). I tried to achieve the best balance possible but in some instances, I have favored training over the location and in some instances, I have favored location above training. I think that the two bottoms 1/3 SLOEs closed some doors for me. and if something doesn't make objective sense on how I've ordered my ROL it is because I went with my gut on some of these things instead of doing mental gymnastics trying to optimize the Training/QOL balance.

1) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
2) FL -- Jackson Memorial Hospital
3) CA -- Los Angeles County - Harbor-UCLA Medical Center
4) MD -- University of Maryland
5) NY -- Hofstra Northwell SOM at North Shore / LIJ
6) FL -- Mount Sinai Medical Center/Miami
7) MI -- Sinai-Grace Hospital
8) NY -- New York Medical College/Metropolitan
9) TN -- University of Tennessee - Nashville
10) PA -- Crozer Chester Medical Center
11) NY - Hofstra Northwell Southside Hospital (Bay Shore, NY)
12) NY -- Good Samaritan Hospital Medical Center
13) PA -- Penn State Health Milton S Hershey
14) FL - Florida State University Sarasota Memorial Hospital
15) PA -- Geisinger Medical Center
16) NH -- Dartmouth-Hitchcock Medical Center
17) AR - Unity Health

Note from @TrashPanda13: Recognize your story from the spreadsheet. Respect. Congratulations on beating cancer and your accomplishments. Best of luck to you.
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Applicant summary
Board scores: 210s/230s
EM rotation grades: High Pass/High Pass
AOA: No
Medical school region: Midwest
Anything that made you more competitive: I wish

Main considerations in creating this ROL: Region

1) CA -- University of California San Francisco/ Fresno
2) OH -- Case Western Reserve University/Metro Health Medical Center
3) MO -- Washington University St. Louis/Barnes-Jewish Hospital
4) OH -- Ohio State University Medical Center
5) NE -- University of Nebraska Medical Center
6) KS -- University of Kansas School of Medicine
7) OH -- Case Western Reserve University/University Hospital Cleveland Medical Center
8) MO -- University of Missouri Columbia School of Medicine
9) AZ -- Kingman Regional Medical Center/OPTI Midwestern University
 
Applicant Summary
Board Scores: 230s/240s
EM rotation grades: Honors/Honors/Honors
AOA: No
Medical school region: Northeast
Anything else that made you more competitive: leadership positions, research, challenging experiences

Main considerations in creating this ROL: mainly "best fit". Some consideration for reputation

1) CT -- Yale New Haven Medical Center
I just felt like it was the best fit for me overall. It was a good balance between county and academics and had great QoL. Great global health program

2) RI -- Brown University
I liked it here a lot but my partner does not want to live in RI. very similar to yale. Great leadership who I enjoyed. Focus on making you the best you can be

3) MD -- Johns Hopkins Hospital
Loved PD. Great program.

4) PA -- Temple University School of Medicine
Only 3 year program that I felt connected with me

5) NY -- Mount Sinai School of Medicine - New York
Was ranked higher but was worried about change in program leadership

6) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
7) NY -- NYU/Bellevue Medical Center
8) NJ -- Cooper Hospital
9) NY -- SUNY Downstate/Kings County Hospital
10) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
11) MD -- University of Maryland
12) DE -- Christiana Care Health Services
13) NY -- Maimonides Medical Center
14) PA -- Thomas Jefferson University
15) NY -- Mount Sinai St. Luke's Roosevelt Hospital Center
16) NY -- New York Presbyterian Hospital
17) NY -- Long Island Jewish Medical Center
I HATED interview day. HATED IT WITH A PASSION .
 
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Applicant Summary
Board scores: 250s/260s
EM rotation grades: Honors/Honors
AOA: No
Medical school region: Midwest
Anything that made you more competitive: Leadership

Main considerations in creating this ROL: Location, favored academic

1) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: Amazing resources. Resident autonomy. Excellent leadership. Weather. Name. Mix of sites. Just felt like there was a sense of excitement about the future here.
Cons: Not a gritty county site. That's fine. Traffic and COL are less than ideal.

2) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Pros: Clicked with the faculty. CHILL/nice residents. Great family feel. Feel confident that the dual sites will provide excellent training. Amazing academic resources.
Cons: Really just the commuting. Olive View seems like a good experience, but it's not a trauma/high acuity center.

3) IL -- McGaw Medical Center of Northwestern University
Pros: The most fun social. Amazing family feel. Really committed to the residents. 8 hour shifts. I feel like I could become any type of physician I want to here.
Cons: Weather is ehh. Seems like great clinical diversity, way less trauma than I'd like but Cook County trauma is wild.

4) CA -- Alameda Health System - Highland Hospital
Pros: Wow these people are amazing. I went to conference and it was SO good. Amazing teachers. You'd be a badass here without trying. I wanted this to be #1.
Cons: SO country. I just know myself and that I'd be more fulfilled at an academic place.

5) WA -- University of Washington Emergency Medicine Residency Program
Pros: I really liked this place. Residents were so fun. I could see myself being a badass and running Harborview's ED. Loved that the faculty go to both sites, seemed to be a sense of pride. The proximity of the two sites is a huge plus and Seattle is a really fun city.
Cons: Off-putting interview with PD. Afraid that this is a new program, and I would be shooting myself in the foot in terms of name recognition/job placement.

6) CO -- Denver Health
Pros: WOW. Clinical badasses. Damn. Residents were hella fun too. Denver is such a fun city. Conference was baller. I'd be so good coming out of here.
Cons: The typical...overworked, not enough elective time. Man this place would be perfect if not for the brutal hours.

7) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pros: In a vacuum, the perfect county program. Super great schedule, living by the beach produces happy residents. A true commitment to teaching built into every shift. Conference was great. Nothing bad to say.
Cons: My Spanish isn't that great. Not my favorite part of LA. Not a good fit for my needs.

8) CA -- University of California San Francisco - San Francisco General Hospital
Pros: 50/50. Fun residents.
Cons: Maybe I just had a bad interview day? Nothing really sold this program to me. Interviews were weirdly formal. Commuting by shuttle to all the sites seems like a drag. I think I'd actually have to like in a shack.

9) IL -- University of Chicago Medicine
Pros: My favorite interview day. Super fun, kind residents, incredible PD. Would get badass county-style training at a incredibly well-respected 3-year academic center. The international flights sound so cool.
Cons: Not my favorite part of Chicago. Residents made comments about Comer peds not being great. Actually worried that the abundance of trauma will put a strain on the hospital and cause problems down the road. Again, just not the best fit for my needs.

10) CA -- Los Angeles County/University of Southern California Medical Center
Pros: Badass training, etc. etc. Interview with the PD was incredible, almost started tearing up because we were talking about such deep/emotional topics. He seems so, so kind.
Cons: It's like Harbor with a terrible schedule. Just not a good fit for me.

11) IL -- John H. Stroger, Jr. Hospital of Cook County
Pros: LOVED the faculty. Would make me an excellent clinician.
Cons: Man, that graded responsibility is tough. Basically running an urgent care for most of first/second year sounds miserable. Not for me.

12) TN -- Vanderbilt University
Pros: Awesome residents. Great training. Really cool that all 3 sites are right there. Wide catchment area. Would live like a king compared to the other places on my list.
Cons: Not a good fit. The Slovis idol-worship seems weird and detrimental to me, overshadows the PD who seems great
 
Applicant Summary
Board scores: 250s/250s
EM rotation grades: Honors/High Pass/Honors
AOA: No
Medical school region: Northeast

Main considerations in creating this ROL: Location, social EM, medically sick much more important to me than traumas. Underserved Spanish-speaking population, not needing a car, honestly all of my top 6 were my #1 at some point--it was really nitpicking details to separate the list

1) NY -- NYU/Bellevue Medical Center
Pros: commitment to social EM was what sold me more than anything, NYC (con for some), amazing job/fellowship placement, residents were all super down to earth, commitment to LGBT/diverse resident recruiting, actually like the floor month (almost did IM), 2nd years work most night shifts, so upper years don't work many nights, 2 black/2 golden weekend all 4 years, new Brooklyn site adds more procedures and some more trauma experience, new children's hospital opening, and ED expansion, awesome breadth of patients (welcome sign is in like 17 languages)

Cons: COL (though residents said they were able to find studios in walking distance and afford it without problems, especially since there are no car/commuting costs), very little subsidized housing available, nursing not as great as other cities, 18x12 first 2 years (residents said they usually were out within a half hour of shift ending)

2) NY -- Mount Sinai St. Luke's Roosevelt Hospital Center
Pros: strong job placement, pared down off service rotations (just tube and go on anesthesia, deliver and go on OB, no notes or anything), guaranteed housing, great residents, NYC (again, con for some), diverse patient mix between St. Luke's and Mt Sinai West, 18x12 first year, then 9s during week and 12s on weekends with 2 goldens/block after. Residents got along great with each other and off-service. One phrased it as "it's hard to scream at someone denying an admission when you know you're gonna see them in the elevator later." Lots of good medical Spanish use at St. Luke's. Really clicked with one APD in particular.

Cons: St. Luke's ED is extremely small and cramped even by NYC standards, felt like peds wasn't as strong here, COL, nursing supposedly better than Bellevue but still not great, off-putting interview with the PD (residents said she is a tough interviewer but they really like her)

3) PA -- Temple University School of Medicine
Pros:Happiest residents I met on the trail, leadership is amazing and read everyone's application in extreme detail and asked very specific questions, really made me feel like they wanted me. Far and away the strongest program in Philly, but they were so humble about everything. Good patient diversity--Temple is inner city mostly AA patients, Episcopal is largely Hispanic/Spanish-speaking, Jeanes is more of a community hospital feel. Best peds training I saw with time at St. Chris for bread & butter and 3 months at CHOP for the zebras and traumas. Tons of trauma (average > a thoracotomy a week) and procedures at Temple. ED runs the hospital and has full admitting privileges. ~$60k with great benefits is plenty to live very comfortably in Philly, and hospitals (minus St. Chris) easily accessible by public transportation.

Cons: The schedule. Probably would've been my #1 if not for it. Circadian schedule (2 7a-5p, 2 1p-11p, 2 9p-7a, 2 off) seems like a good way to disguise 22 10s per block as "wellness." No golden weekends all 3 years unless 2 off happen to fall Sat/Sun, first day off is coming off an overnight, hard to switch shifts with co-residents. All that said, residents were happy and didn't seem to mind it--I just wasn't crazy about it. Maybe too much trauma? Full admitting privileges not representative of how the real world goes. Not much social EM.

4) MD -- University of Maryland
Pros: Probably the best pure educational program on my list, with a strong interest in creating educators. Learning EKGs from Dr. Mattu, airways from Dr. Butler, etc. Took us to conference during interview and I learned a ton in an hour. 5 months at Shock Trauma. Strong ICU experience. Lots of community experience too. Moving peds to Hopkins from D.C. Have the 3+1 structure where you can get junior attending salary to stay on and do a fellowship, with some awesome fellowship opportunities--can do things like cardiovascular or neuro emergencies to EMS to health policy. Some people were put off by PD--I personally loved him. Straightforward, funny, and you could tell he truly cares about the program and wants the best residents in it. Baltimore is a good city--not NYC or Philly level--but definitely not The Wire anymore either.

Cons: Not much social EM (though PD said they are actively working on increasing this), homogeneous patient population, q3 24s on trauma with ~30 traumas a day sounds brutal, residents didn't seem burnt out, but they definitely didn't seem like they hang out much. Felt like their peds ED was small but this might've just been me, as they're one of the few programs in the country with EM/peds residency. 18x12 with shifts that seem to go over, but they only spend like 7 months or something over the first 2 years at the UMD ED--other time in community (with 8s and 10s)/Hopkins peds/off service. 16x12 as a 3rd year. I liked NYC and Philly better than Baltimore. Not much Spanish.

5) TX -- Texas Tech Health Science Center/Paul L Foster School of Medicine
Pros: Lots of patients don't have insurance, so come in in end-stage presentation. Nec fasc, potassium of 9, etc. Get comfortable managing very sick patients. Awesome pathology--will see lots of TB, coccidiomycosis, and diseases that don't really exist in the US, but are in Mexico. Hospital is less than a mile from the border. It's a county hospital, but the ED was just redone and looks like a private academic hospital. Huge focus on Latino immigrants and service. The PD is super responsive to residents' needs and is working to strengthen the program--adding rural EM rotation which sounds like it will be a great experience. New APD from Cook County brings a lot to the program. Will be fluent in medical Spanish more so than any other program outside of Puerto Rico. Sim center is world-class. PAs siphon off less educationally-rewarding cases. Best benefits of anywhere--fully paid health and dental for resident and family with high quality Blue Cross insurance. Salary is low, but El Paso is ridiculously cheap--can afford a new construction 3 bedroom house pretty easily on residents budget--many residents buy houses. Lots internally moonlight for $85/hr. Residents all super relaxed and easy to get along with. Starting salary for attending community jobs in El Paso is ~$300/hr if you end up staying.

Cons: I think I want to do academics (social EM interest) and almost everyone here does community unless they stay on as faculty. As a single person, El Paso is not the most happening place. If I was married and set on community, would've been my #1. I think the quality of training is on par with the others (minus the trauma). El Paso is one of the safest cities in the country, so not much penetrating trauma (despite what the president says), though it is only trauma/stroke center for 250 miles, so get a good amount of blunt trauma flown in. Boarding is a big problem, especially psych patients. Residents said peds experience not as strong as they'd have hoped.

6) FL -- Jackson Memorial Hospital
Pros: Didn't expect to like here as much as I did. First time in Miami--loved it though I could see how not for everyone. Definitely would not mind living in South Beach for a couple years. They are explicit that they are intentionally recruiting people from all over the country and not training just Florida doctors, but rather doctors who will be leaders throughout the country. Jackson is cool because it's the county hospital and the major tertiary referral center for the area so you see lots of different patients. Crazy busy ED with amazing pathology from all over the Caribbean. The residents were awesome and very happy. Didn't seem overworked at all. 9s during the week and 12s on the weekend. Guaranteed 1 golden, usually get 2. Can also request off 3 days per block. Peds seemed pretty strong. The whole health campus was really impressive. Leadership is awesome and down to earth. I think in 10 years this will be one of the elite programs of EM. Lots of Spanish speakers.

Cons: Got asked a couple times if I was insecure about it being a new program--I wasn't but the fact that they asked made me start to feel a little insecure. It is a new program--though 3rd years got great fellowship/job placements. Anesthesia owns traumatic airways. Traumas go through Ryder, but EM residents rotate on Ryder team and said they never had trouble getting tubes or trauma procedures. The main reason it dropped was that $53k didn't seem like nearly enough to live in Miami, and there was a 60 mile round trip commute to Ft. Lauderdale for 1/3 of the residency.

7) DC -- George Washington University
Pros: Focus on educators. PD is committed to helping you find "your thing" in EM. Lots of health policy opportunities (can spend 4th year working on the hill and they will help schedule your ED shifts around that). Now getting a helipad so should see more traumas. Awesome maritime/event medicine experience. Located in Dupont Circle. Treat the VIPs!

Cons: Only place where multiple residents remarked on how tired they were. Not a peds hospital. Need to commute to Fairfax a decent amount. Single residents couldn't afford DC, most lived in NoVa and commuted in--don't want to deal with the commute, and now Amazon is coming to NoVa and will drive up prices there anyway. Chair has done a lot of great things, but I was really turned off by the way he talked to us.

8) PA -- Thomas Jefferson University
Pros: Endless resources, new PD is amazing and sells the program well, ED is beautiful--has a fully stocked and ready OR in the middle of the ED, off service rotations are very strong, big focus on telemedicine which isn't really my thing but is likely the future of triage and follow up. 2 months at CHOP. Cool event med--cover all the sports teams except Sixers and Union.

Cons: commute to 6 hospitals, no longer go to Cooper for traumas, commute to DuPont in Delaware for most peds shifts. Not a big underserved population. Hardly any traumas, lots of drug overdose and nursing home patients. Moving to circadian schedule like Temple.

9) NJ -- Cooper Hospital
Pros: Still live in Philly and easy commute, great trauma exposure, big focus on service, large Hispanic population, well-regarded in EM

Cons: Really wanted to like here, but got a lot of pretentious vibes that I didn't feel anywhere else. I don't know if it was just the way I was interpreting things or what. I think they're confident in their grads and their program, but it seemed over the top. The PD said something along the lines of "don't come here if critical care isn't your thing." It's not my thing.

10) AZ -- Maricopa Medical Center
Pros: Well-regarded in EM, PD is awesome, 3 months of electives and they focus on helping you use them to maximize your career options. They really want you to forge your own path and are committed to doing anything they can to help you--including creating a new fellowship. Have new partnership with Creighton and Mayo Clinic that will increase opportunities. Burn ICU sounds great. Residents all seemed very competent. Love Phoenix as a place and cheap COL. County as hell. Lots of Spanish speaking patients.

Cons: ED felt small and not that populated. Not a stroke center, need to go to Banner to get experience managing strokes. End up going to a lot of different hospitals because Maricopa doesn't see all that much. Hospital in general seemed run down (even by county standards) and off service rotations were questionable. PD said a new hospital is in the works, but won't be while we're there. All that the residents kept talking about was hiking and biking--which I enjoy...to an extent. I wanted to like here a lot, but just didn't feel the "click." Found it weird that none of my Lyft drivers or people I know in Phoenix had ever heard of MMC.

11) TX -- University of Texas Houston
Pros: Lots of very sick patients, insane 45% admission rate, trauma is amazing--during the interview they helicoptered in a guy with his arm severed clean off and the residents were like "yeah, happens more than you'd think." PD was very down to earth and said he thinks the program is ready to jump into the "elite" sphere. Get a top notch academic and county experience. Residents all seemed super relaxed and got along great with each other--they all really enjoyed it. Lots of elective time. Want to increase social EM focus. Lots of resources in the program. Tons of Spanish speakers. Great pay vs COL.

Cons: Don't know anyone in Houston. Most of the residents seemed to be staying in Houston, which I don't plan to do. The two hospitals are on opposite sides of the city and it seems like the commute is a bear regardless of where you live. Got pimped on what journals I read, podcasts I listen to, and FOAMed I use by one interviewer. Another just only asked what questions I had to the point of being awkward.

12) DC -- Georgetown University Hospital/Washington Hospital Center
Pros: 1-on-1 with attending for shift. Great trauma and medically sick patients at WHC. 22/21/20 9s per month (not 4 weeks). Lots of health policy options (though not as much as GW just by nature of being a 3yr vs 4yr). Dr. Bhat seemed like someone I could learn a lot from.

Cons: Georgetown Hospital is a small community ED where many patients are either MTF or have like metastatic pancreatic cancer and you just call the oncologist and let them manage it. Residents only manage traumas at WHC certain nights or something weird like that. Interviewers seemed a bit odd and more distant than at other places. Really though, like GW, I liked the program but it came down to COL--it seemed residents couldn't afford to live in DC--they lived in NoVa or southern MD for the most part. Don't want any part of suburban life or the commute into DC.

13) PA -- Albert Einstein Medical Center
Pros: High acuity, live in Philly, decent trauma experience (Temple > Einstein > others in Philly). Huge variety of required rotations (NICU, ophtho, etc)

Cons: No one smiled the whole day except one interviewer. Residents seemed strong but overworked. They claim to alternate traumas with surgery, but surgery generally kicks the EM residents just to managing the airway and doing primary survey. Sold 4th year as "more time to learn EM," which didn't convince me. Very limited elective time. Felt a strong DO bias against MDs. Not really anything in the way of research going on. Not much social EM (said they brought on a person doing something like that). Interview day seemed unorganized. Off service surgical rotations mostly overworked IMGs. Almost entirely low socioeconomic status patients, though do have robust transplant program. In general, though, not as many medically complex patients. Unclear how Jefferson buying it will affect residency (PD said it won't).

14) LA -- Louisiana State University - New Orleans
Pros: Tons of trauma, I think it rivals UMD and Temple for quality of trauma training if that's your thing. Huge focus on social EM and community outreach, with myriad opportunities in New Orleans. The hospital is beautiful--I didn't see a nicer place anywhere I interviewed. It's set up to be pretty much apocalypse-proof and with art everywhere. Have really cool, useful rotations like rural EM, and Ochsner has a huge transplant program so you get some more of those complex patients there. Super cheap COL. Residents mentioned liking to drink multiple times and the interview swag was beer koozies. They actually took us out to eat to a real restaurant for po' boys and we got to talk with the residents, who drove us there. Residents were awesome and hilarious.

Cons: Just could not see myself living in New Orleans at all--the atmosphere was thick with jazz and vomit wherever I went, and I only enjoy half of those. If you like NOLA, this would make you a fantastic physician. No one read my application at all (which might have been intentional, just wish they would have said so up front). No Spanish speakers.
 
Applicant Summary
Board scores: 240s/240s
EM rotation grades: Honors/High Pass/Honors
AOA: No
Medical school region: Southeast
Anything that made you more competitive: ***DO Student***. Multiple national leadership positions, EM scribing before and during medical school, EM quality assurance project, lots of volunteering, prior career.

Main considerations in creating this ROL: Location, Prestige, County Program, Want to work hard but not to the point I am burnt out at the end of residency, 3 years>4 years.

1) FL -- University of Florida - Jacksonville
2) CA -- Los Angeles County/University of Southern California Medical Center
3) FL -- Orlando Regional Medical Center
4) FL -- University of Florida - Gainesville
5) CO -- Denver Health
6) TX -- University of Texas Houston
7) TN -- University of Tennessee - Nashville
8) LA -- Louisiana State University - Baton Rouge
9) FL -- Kendall Regional Medical Center
 
Applicant Summary
Board scores: 240s/240s
EM rotation grades: High Pass/High Pass
AOA: No

Main considerations in creating this ROL: How happy I would be there

1) AZ -- University of Arizona
2) TX -- TX A&M Scott & White Memorial Hospital
3) MI -- William Beaumont Hospital
4) MA -- University of Massachusetts
5) FL -- University of Florida - Jacksonville
6) FL -- University of Florida - Gainesville
7) MI -- Sinai-Grace Hospital
8) OH -- Wright State University
9) NY -- Hofstra Northwell School of Medicine at Staten Island University Hospital
10) MA -- Baystate Medical Center
11) PA -- Penn State Health Milton S Hershey
12) NJ -- Hackensack University Medical Center
13) MI -- Western Michigan University Homer Stryker MD School of Medicine
14) LA -- Louisiana State University - Baton Rouge
15) NY -- New York-Presbyterian - Queens
16) NY -- University at Buffalo - SUNY Buffalo
17) NH -- Dartmouth-Hitchcock Medical Center

Applied to: Quite a few
Declined: ~10
Interviewed: All ranked
Rejected: ~25
 
Applicant Summary
Steps: 230s/240s
Comlex: 640s
EM rotation grades: Honors/HP/Honors
Anything Else: DO applicant. leadership experience. Nothing else really.

Main considerations in creating this ROL: Fit/vibe with program, program’s mission, patient population, COL

**life circumstances changed drastically for SO/ family, made geography more important than I would have liked**

1) CA – Kaweah Delta
Pros: Really enjoyed every interaction I had with the program. Instant connection with couple of the faculty members there. Good pathology, acuity, and autonomy. Patient population I want to work with. Although newer program, residents respected within hospital. COL. CA central valley, a negative for most, but + for me, have lived up and down the 99 before. Great benefits.

Cons: Newer program. Community program so might limit the 5% of me that is considering academics, although they have fellowships coming.

2) CA – University of California San Francisco - Fresno
Pros: Established, well respected program. Badass training. Holy volume batman. Largest physical ED I have seen, with patients to fill it to the seams. Trauma. Although many are transfers that have been “packed up and shipped in” Fresno gets its fair share of penetrating trauma as well. Amazing faculty invested in teaching. Seemingly set up to seek any career path: academics, fellowship, community etc. Location. Access to outdoor activities. COL.

Cons: 4 years, lacking resources, residents all seemed like the same person at times.

3) AZ – University of Arizona – Main campus
Pros: Established, well respected program. COL. Renowned faculty. Patient population. Really liked the exposure to border-health and how it ties into the EM niches of social medicine / global medicine. Shifts schedule. Residents all seemed happy and I felt that family vibe. Winter.

Cons: Banner merger, still unsure how it will affect residency long term. Summer

4) CA – Desert Regional Medical Center
Pros: PD. Loved the leadership/mentorship of Dr. Stillings. Great resident autonomy with acuity/pathology to match. Residents were all uniquely weird (good weird, quirky?), and yet had a true family feel. Made you feel like your weird/uniqueness would be more than welcome to the family. Huge catchment area. Location.

Cons: Newer program. Peds month is Sac. Transient city with constantly shifting population.

5) TX – Texas Tech Health Science Center/Paul L Foster School of Medicine
Pros: One of the best IV dinners I attended., great groups of residents. Patient population. Really liked the exposure to border-health and how it ties into the EM niches of social medicine / global medicine. Pathology that comes with uninsured migrant population, end stage everything. New ED. COL. Opportunities for internal moonlight and/or teaching at medical school for extra $.

Cons: Volume down trending with more ED’s in town. Not the biggest fan of 12’s

6) NV – University of Nevada Las Vegas
Pros: County patient population. Poor follow up/access to primary care in Vegas = pathology. North Vegas = trauma. Great peds EM months with continued longitudinal exposure. COL. SO bumped this higher.

Cons: 12’s. Didn’t connect well with PD. Residents were burned by 3rd year. Morale/relationship between residents and nursing/ancillary staff wasn’t the best.

7) IL – University of Illinois Hospital - Chicago
Pros: Established, well respected program with large alumni network. Academic opportunities. Dedication to diversity in medicine, reflected in their residents and faculty. Residents seemed like a genuinely happy and honest group. Social medicine / global medicine programs interest me. With 4 core clinical sites you truly serve the different patient populations in the city: Mercy (low SES); UIC (low SES, tertiary care type patients); Masonic (LGBT community, high SES); Lutheran (community, suburbs).

Cons: commuting to the 4 sites, polar vortex

8) NY – SUNY Downstate/Kings County Hospital
Pros: Established, well respected program with large alumni network. Graduate placement was phenomenal. Legendary training. Brooklyn. Dedication to diversity in medicine, reflected in their residents and faculty. Call me a sucker but sold by the IV and what they were selling. The patients, mission, acuity, training…all of it, ate it right up. Was ready to sign on the dotted line day of IV.

Cons: COL. NY nursing. SO bumped this down, was WAY higher initially ={

9) IL – Loyola University
Pros: I really liked Dr. Snow and his vision for this new program. The facilities at Loyola paired with an established hospital GME system made me feel more at ease about the “newness”. The patient population Loyola serves would provide great clinical training with a mix of low SES and tertiary care patients. Level 1 trauma, burn, EMS resource hospital. Mission.

Cons: New program, will be Guinee pig. The need to establish relationships with EVERY service. Polar vortex.

10) CA – Eisenhower Medical Center
Pros: Beautiful facilities. Funding seemingly not an issue for this program. Location. COL. Winter.

Cons: New program, will be Guinee pig. The need to establish relationships with EVERY service. NO trauma in house. Not sure high SES is the patient population I want to work with. Unsure of acuity/pathology in a well-off community.

11) NV – Sunrise Health GME
Pros: COL. Cool residents. Curriculum/didactic set up seemed innovative. Shift schedule was nice! (too nice?).

Cons: Newer program. Home base is NOT Sunrise hospital, but Mountain View.

12) CA – St. Joseph’s Medical Center
Pros: Stockton’s population will provide the acuity. Nice facilities with true community feel.

Cons: New program, will be Guinee pig. The need to establish relationships with EVERY service. Hospital GME adding a TON of new residencies in the next ~5 years, will be in constant flux. NO trauma.

13) PA – Albert Einstein Medical Center
Pros: Established program. Sick Philly patients.

Cons: 4 years. IV didn’t go well.
 
Applicant Summary
Board scores: 230s/250s
EM rotation grades: High Pass/Honors/High Pass
AOA: No
Anything that made you more competitive: Unique ECs.

Main considerations in creating this ROL: "Gut" and finding a place and people I would be happy spending the next 3-4 years is king, but individual programs features I thought were important are as follows:
1. Clinical training: acuity, volume, diversity of patients/pathology, ideally all under one roof rather than segregated sites,
2. location- I like outdoors stuff but also want a city with fun things to do, decent weather and a good airport,
3. Alumni network and/or prestige to get that sweet SDG or out-of-region job later
4. Autonomy within the hospital and ideally not over-consulting, would like to get good procedural #s
5. Program perks: how many shifts/month, elective months, vacation weeks, unique electives etc. I see myself most likely working community, but do enjoy teaching so may want to come back to academics or do a few shifts/month at an academic center or with residents in some fashion.

1) AZ -- Maricopa Medical Center
Pros: Great PD, most fun residents, felt like I could take the opportunities given here and run with them, rotates at the "best" learning opportunities in the whole city, even stopping doing OB at their home hospital (noteworthy that WashU residents travel to copa for OB) to go to a higher-volume center in the city. COPA PRIDE alumni network. Didactics had some of the most passionate discussions by attendings I have seen that really enhanced the educational experience. Electives start in year one and they will help you make electives geared towards your interests.Urban under-served population and spanish speaking, but see other and tertiary patients at other sites.
Cons: HOT in summer, other level one centers, questionable creighton merger

2) MO -- Washington University St. Louis/Barnes-Jewish Hospital
Pros: Biggest surprise on the trail- came in very anti-4 years but I drank the koolaid. County + Academics all under one roof, great trauma experience, strong CC, ED has a surprisingly good role in the hospital for a place with such strong IM and surgery programs, fun residents and my favorite PD on the trail. IV day swag (socks) may be my favorite from the trail.
Cons: 4 years, St. Louis isn't the best but certainly not the worst either, residents seemed to think training would be ideal in 3.5 years.

3) TX -- UT Southwestern Medical Center - Dallas
Pros: Probably my 2nd favorite city on the trail only after SD, most fun pre-interview dinner, tons of volume at UTSW in a nice facility- get to treat urban under-served patients without the typical lack of resources that often comes with. Saw attendings and 3rd year residents do some good teaching on shift. Good alumni network. Opportunity for spanish.
Neutral: New Zealand is cool, but didn't really factor into the spot on the list
Cons: Bad trauma experience, possibly over-consult heavy. Would prefer a smaller class size.

4) NM -- University of New Mexico
Pros: Fantastic CC experience with 9 EM-CC double boarded docs from great institutions. Large catchment area. Good procedural volume. ED very strong in the hospital. LOVE the surrounding mountains. Most attendings very down to earth and very involved in teaching.
Neutral: Lots of EMS- not really my thing though.
Cons: Slightly weaker peds than 3 above it? Boarding issues in ED. Cerner EMR. Albuquerque is very dry and doesn't have a ton going on

5) FL -- Orlando Regional Medical Center
Pros: "tri-brid" and surprisingly high admit rate and trauma for a community hospital. Few competing residencies should give high procedural volume. Great peds and OB facilities and volume. Good interview day. 4 weeks of vacation and good elective time.
Cons: Not a huge disney fan. Far from my ideal practice location and unsure if the alumni network is strong outside of the southeast (honestly could have gone as high as #3). paper charts. Old PD died, although new one seems very confident and invested in program success.

6) NC -- Wake Forest University
Pros: Established, high acuity, good academic reputation, good procedural volume and role in hospital, strong peds
Cons: Wake forest is a small town without a ton of industry outside of healthcare, far away from large airport.

7) CA -- Loma Linda University School of Medicine
Pros: I liked the area, residents nice, good role in hospital (alternate trauma captain every other day), new hospital in 2020. Split time b/t university and county hospital.
Cons: Not great IV day. Small town without many other industries. CA expensive to live

8) CA -- University of California San Diego
Pros: Location- my favorite city on the trail. weather perfect, near tons of outdoor activities, I would be very happy here
Neutral: flight med- but not really my thing
Cons: 4 years, low acuity and poor trauma set-up (like UTSW but seemingly less crazy stuff comes here than parkland), overly academic

9) MN -- HealthPartners Institute/Regions Hospital
Pros: I would love to work at a hospital like this after residency and I'd be happy to be a patient here- very efficient level one center with great metrics, varied patient population, EM well represented in hospital leadership. EM has a good role in the hospital. Attendings willing to teach.
Cons: Not quite bat****-crazy enough for me. Alumni mostly stay in the area. Don't want to have to say "I go to a place in the twin cities, no not Hennepin, the other one."

10) FL -- University of Florida - Jacksonville
Pros: True county. Great procedural volume, PD faculty on difficult airway course, good role in hospital. Fun pre-IV dinner and residents.
Cons: Lack of diversity? (see almost only low SES patients), unsure of peds exposure, crushing intern schedule. This program would be higher if I liked Jacksonville a bit more- felt like everything was a long trip on the highway away.

11) MN -- Mayo Clinic School of Graduate Medical Education
Pros: great name, surprising amount of bread and butter and alternate trauma captains. Lots of elective choices. Can hop on research super easily. Had a really good IV day with faculty.
Neutral: Rochester. Great COL and some decent stuff to do compared to similar sized cities, but very cold, and far to twin cities airport
Cons: I'm afraid of having too many resources, never having to deal with running out of beds in the hospital etc. Almost everywhere in the world you will be working with "less" available than you have here, and I don't want to be lost without all the newest fanciest toys. Not enough penetrating trauma for my tastes. I would prefer to see more urban under-served and fewer quaternary care patients

12) WI -- Medical College of Wisconsin
Pros: Alternate trauma captains, dept chair new SAEM president elect, established program with alumni in 49 states. Tertiary and under-served all within the same hospital. Good peds exposure.
Cons: Poor IV day communication and poor dinner turnout, too suburban for me

13) TX -- John Peter Smith Health Network
Pros: Few competing residencies means lots of procedural volume in a very busy ED. I really wanted to move this program higher because I think they have the ingredients to make something really cool (in a few years?) but just couldn't make myself do it.
Cons: Fort Worth seems a lot less fun than Dallas. Residents were nice people but I'm not sure we had much in common. Low salary compared to UTSW. Lack of alumni network outside the region and lack of name recognition (you did residency at John Jacob Jingle-who?) might make difficulties getting jobs outside of the region- I'm just afraid that if I want a job at a SDG outside the region I may be at a disadvantage.

14) MO -- Truman Medical Center/University of MO Kansas City
Pros: established residency, chill IV day, nice residents, urban under-served population. KC is pretty fun, and BBQ is good (favorite pre-IV dinner restaurant).
Cons: Lack of diversity (see only urban low-SES patients) and some acuity and pathology may go to KU or other hospitals in city. Facilities outside of the ED are dated, even if the ED was pretty nice.

15) MO -- St Louis University School of Medicine
Pros: Fantastic combo of urban under-served/trauma and tertiary patients (yes, SLU has transplant, etc.) similar to WashU. Good community exposure with a high number of community months. New hospital in 2020 with larger ED although total hospital size will stay the same.
Cons: Poor relationship with other services in hospital. Hospital on hiring freeze leading to low morale. Residents are a mixed bag- some very strong, others not as much. Overall culture of attendings could improve- I imagine it's like an old school NY style residency (though I didn't IV there). The reason this program is #15 and WashU is #2 is the difference in culture.

16) MI -- Wayne State University Detroit Receiving Hospital
Pros: One of the original EM residencies and some of the most fun residents on the trail, seem to have good comaraderie with ancillary staff as well. Unique pod system allows you to really move the meat.
Cons: DRH and Harper Hutzel may lose Medicare funding after failing a site visit??!?!?! Also low salary. Detroit cold and not really my vibe. Also feel that due to demographic shifts in Detroit DRH no longer sees as much trauma as they used to, and while on one hand having lots of EM residencies in Detroit is cool for collaboration, it seems like each hospital has a niche and patient subset rather than seeing people from all walks of life. I don't like the split between DRH and H-H, I'd much prefer all those patients under one roof. Poor patient diversity at main site.

17) MI -- Sinai-Grace Hospital
Pros: EM king of the hospital, great trauma and procedural experience.
Cons: I want more academic off-service rotations- some faculty and residents admitted that teaching not strong on some off-service rotations, and while autonomy is good, I don't want to be thrown to the wolves in an ICU without backup. Seems like few tertiary patients and low diversity.

18) TX -- TX A&M Scott & White Memorial Hospital
Pros: Cheap COL. Good for families or if you're dead set on community medicine. Nice faculty and residents.
Cons: Temple, TX way too small for me- I've seen it compared to Rochester MN but S&W is no Mayo, and Temple is no Rochester. I got this interview early and would have preferred some of the programs I got late or declined over this.

Anything to add? Applied very top-heavy, got none of the "legendary"/ top doximity programs, but got ~50% yield for programs past rank 40 or so on doximity.
Declined: Vermont - Loyola - UH cleveland - Stony Brook - Maine - UC Riverside
 
Applicant Summary
Board scores: 240s/250s
EM rotation grades: Honors/Honors/Honors
AOA: No
Medical school region: Southeast
Anything that made you more competitive? Previous ED scribe, family in specialty, 3 top 10% SLOE's, ***DO student.***

Main considerations in creating this ROL: Fit with program and residents, Location (wanted my SO to have a good job market, he supported me throughout med school, didn’t want to stall his career for 3 years) >>>> everything else. I like to be very hands on and allowed to think for myself on patients, so I took that into consideration. Was unsure about fellowship, so that didn’t factor much. Felt the training at any of these would be great, just tried to find the program that hit as many checks for me

1) FL -- University of Florida - Jacksonville
Rotated here and absolutely loved it, the residents are all laid back, the attendings are very chill and up to date. Residents regularly went out with each other when I was there, and despite what people say, the interns did not seem overworked, they do get a lot of autonomy upfront and I think that’s a great thing because I learn by doing, they work 21/28, they also get all medical airways, the shift schedule is great moving up: by 3rd year: 16ish shifts per month. I love to get my hands dirty so a county program was right up my alley, nothing is shiny and new. Honestly thought a 3rd year was an attending on my first shift. Have a chief of the day/charge resident system so that a 3rd year is essentially a pre-attending running the department, 2nd years run medical codes/resus, 1st years work more on the Flex care side where attending is able to do a lot of teaching with some shifts on the ECC (high acuity side). Attendings are always around to do teaching. National airway course is taught here. SO job market is huge here, Jax is close to family, able to easily find a house to rent, beach is close, tropical weather all the time. Warm fuzzy feeling just typing this.

2) NC -- University of North Carolina
Dr. Binz seems like a badass lady to work for, everyone was really excited to talk about what UNC had to offer, and they have a ton of fellowships on site. A little less than half the ED time is spent at WakeMed (huge community site), lots of procedures there, lots of volume, but have to commute around 40ish min, which wasn’t that big of a deal to me, but the housing is a little more expensive than what we were looking for (we have two dogs, so we want a fenced in yard for them, and were not looking to buy just yet, so wanted to rent, would live in Durham more than likely because it is cheaper). Really loved the people here, but felt like it may be too academic for me, I like to get dirty and do things on my own (within reason), but the people were extremely down to earth for it being such an academic center, which is why its this high on my list.

3) MO -- Truman Medical Center/University of MO Kansas City
Loved the pre-interview dinner, everyone was down to earth and I could really see myself grabbing a beer with any of them. This is a county program so I loved that. I didn’t like how the interns were made to just watch traumas at first without any involvement, I don’t think I would like not getting in those until 2nd year. ED seemed really nice for a county ED, great peds experience with the huge childrens hospital right across the street, longitudinal. The interviews with the PD and APD kinda turned me off a little from this program, I hate the stock interview questions (Tell about some adversity in life…etc) and that was those interviews were, so hard for me to get to know them and vice versa, but still loved the residents and the location enough that this is still #3 on the list.

4) SC -- Palmetto Health Richland
Really loved my interview with the PD and APD’s here, they left it open-ended and just wanted to get to know you without setting a time limit. The PD seemed like a great guy to work under and seemed like he would really go to bat for his residents. They have a lot of fellowships here, and really big into global health and EMS (2 things I’m really interested in), and are a well-established program. Not too sure on living in Columbia, didn’t really impress me on interview day, and the job opportunities really sucked for my SO, but it was super close to our home now. COL is great here, lot of unique electives and seem to really be into tackling physician wellness with lots of lifestyle lectures (finance, retirement, etc.)

5) NC -- Wake Forest University
Everyone was very open about strengths and weaknesses of the program, with ICU being one of their strong suits (they do 5 months of it). The people I interviewed with were great, and I loved that they just wanted to get to know me. They have a ton of opportunities for fellowships and from what the residents said, the attendings like teaching on shift, and the attendings on the ED walkthrough were very welcoming even with it being busy. The city is small compared to what I’m used to, and they had decent jobs for SO, but not a lot of them, The best thing about WS is the COL, you can literally buy a decent home as an intern less than a mile from the hospital and be in a good neighborhood. That being said, I’m not sure how much acuity and pathology is really happening in WS, hence why it fell lower on my list, and I really didn’t vibe with the PD, he had his game face on a little too much for me on the interview day. This sucked because it has a lot of opportunities for fellowship that I really liked about the program.

6) SC -- Greenville Health System
I loved this interview day! I have family that has lived in Greenville for generations (grandparent grew up here, used to visit every summer, family runs the fire department, etc.), and it has changed so much in those years, for the better. Tons of breweries, and outside things to do, the downtown is amazing now and the COL is so cheap. The hospital has always been a big part of the city, and it looks amazing, plus the benefits are out of this world (relocation money, iphone, salary is great, starbucks, sushi, lots of food money). The PD is very enthusiastic about the program and very open to resident led change, she is so easy to talk to, and I honestly loved every faculty I met (it is the south). The ED sees a lot of volume and the residents said they get a ton of procedures, a lot of them are from the area, but others said they had no issue with matching at a new program. This program did not feel like a new program at all, just not a great job market for SO (technology field).

7) KY -- University of Kentucky
Rotated here, loved the people and the ED, its big and shiny and they have everything you could possibly need. Felt really academic, consults being called for everything, lots of transfers that just needed to be babysat while the consult was called. The residents did seem really competent though despite this and they were really fun for that month I was there, they loved going out and they were all super down to earth and my people. They see a lot of sick patients and the interns can get involved early on, which I love. COL is great here, but there just isn’t a big market for SO, except for at the university. Was initially my top choice until I rotated other places/started interviewing and found that I wanted a place that was a little bit less “academic” for me, it’s just how I learn, I need to do/see a lot, and connect with my faculty. But this is a fantastic program, and they’re huge on US (obviously, they have Jacob Avila – 5min SONO), and the PD is a very down to earth guy that’s easy to talk to, and could definitely see going to bat for a resident, and Di Black is literally the best person I’ve ever met. Just had to go lower on my list for things that had nothing to do with the program.

8) VA -- University of Virginia Health System
Program is a huge tertiary care center, has a lot of fellowships/opportunities for you to explore as a resident. The PC was amazing on interview day, and you could tell the residents were like her “kids”. They have a new PD, she was fantastic to talk to and really wanted to get to know me and how I came to be where I’m at now, and she called the EMS program director to come in and talk with me when she found out how much of an interest I had in it, which made me feel special 🙂. They see a ton of crazy pathology, especially in the peds ED, they are they only hospital is this area of Virginia. Charlottesville was too expensive for me, and is really small, but the outside activites are amazing. We had a good turn out of residents at dinner and everyone seemed really happy, even the interns. Thought it was weird that the 3rd years don’t moonlight, they have the opportunity, they just said they choose not too….

9) Medical College of Georgia
Really didn’t expect to love this program as much as I did on the interview day because its in the middle of nowhere GA, but the people were fantastic and sell the **** out of it. They have a ton of opportunities that they have access to through the military (they’re half military), like a live pig lab for thora’s, etc. Lots opportunities for the residents to explore niches during training, very enthusiastic faculty, and the residents were the best, had the easiest time talking to them at the dinner/interview. This just isn’t the city I want to live in, especially with a SO who works in the technology field. But the COL is amazing here and the moonlighting rates are insane, but had to put other stuff over that. Very solid program.

10) LA -- Louisiana State University - Baton Rouge
Essentially unopposed residency since there is no general surgery program, so all of the procedures/traumas are all you, which I loved. The patient population is super sick, so no doubt that you will see some ****, was really impressed with the program and opportunities. The residents were all extremely fun, we all went out after the dinner to bar they frequent and it was blast. Really jived with the faculty and PD, he seems like a awesome guy to work for. The city is alright to me, it has LSU there so SEC football, COL is okay, but not a big city for jobs for SO and not sure if I wanted to live in LA.

11) LA -- Louisiana State University - New Orleans
Loved the interview day and the residents here, everyone was super welcoming, and I really vibed with the PD and other interviewers, PD is brand new but seemed well equipped to tackle it, that didn’t give me any pause. They have an awesome social mission which I really loved, they give back to their community regularly. County program, charge resident system like UF-Jax so the 4th years seemed bad ass. Didn’t really think I could live in NOLA, I want a house with a yard, and there wasn’t a whole lot of job opportunities for SO. Most residents seem to stay in the area after graduation and it’s a 4 year program, which is sad because I loved it. NOLA just wasn’t the city for me.

12) SC -- Medical University of South Carolina
Charleston is definitely a tourist city, it was hell getting into where my hotel was, and there is a ton of people there. As for the program, loved the PD, he had a great sense of humor and it was super easy to talk to him (had a bottle of tito’s on his office shelf +1). The residents all seemed fun and like they got along. I think the city is what turned me off, and its expensive for what me and my SO want. I also didn’t really like that they had a separate chest pain ED that was down the street, even though residents rotate through, just didn’t sit right with me and what I think my training should be (what do I know).

13) MO -- St Louis University School of Medicine
The residents all seemed great and really wanted to get to know us at the pre-interview dinner, and had no problem answering any question we had honestly. I did not jive with the PD, I know people who went to this school and said that’s just how he is, but it wasn’t my cup of tea and I don’t think I could come to him as openly as I want out of a PD. The other faculty were awesome and the city of St. Louis sees some **** so I know the ED would be crazy for training (in a good way). This isn’t last on my list because the city has good job opportunities for SO.

14) MA -- Baystate Medical Center
Rotated here and I loved the residents, we went out regularly, and they all seemed to hang out a lot. They were super inclusive during my rotation, getting me involved in everything I wanted, and the upper levels did that with the interns as well. Springfield sees some sick/crazy patients and their ED is huge, and residents are involved in pretty much everything. Really loved this place, but I didn’t vibe as well with the attendings, they didn’t seem as approachable to me, plus, the area does not have a lot of jobs for SO, and I don’t think I’m ready to move that far north. Otherwise, this place was awesome and I have no doubts you would be badass here, the PD and APD are amazing and regular contributors to CORD so I got great advice here.

15) GA -- Wellstar Kennestone
I really wanted to like this place a lot more, it has everything that Atlanta has without the traffic and can very easily get in and out of atlanta without having to live there, and outdoor **** on the west side. But I just didn’t vibe with the PD, he left such a bad taste in my mouth, he seemed overly arrogant as a person to me and I didn’t feel like I could thrive working under him. The program itself is awesome, huge community hospital that is busy as ****, and you will do everything, which I love, they’re building a new ED that is opening in 2019, and the other attendings I met were all super into teaching, and I was impressed with the residents. I loved the fact of getting to build a program from the ground up, I think they have amazing faculty in place to where they won’t have any of the growing pains another new program might. That being said, it takes a special person to want to be the ones building the rep, and the residents here seem like they have that, they sold the **** out the program to me.



Advice to upcoming 4th years: SLOE’s are king, they will make up for a lot of things (or tear it down), and I definitely suggest really researching where you want to do your aways where they are places/types of programs you want to match. Your peers also have a lot of information about other programs, can help you gauge yourself, etc., but take that with a grain of salt, because your peers can still be dicks. Really figure out what’s important to you, whether that’s training type, prestige, SO input, whatever it is, just try to figure it out and stick to that. You’ll be a lot happier and probably come out a better doctor for that, don’t let the trolls tell you that you suck because you wanted to rank this program over that program, it’s your happiness, so own that ****.

Applied to: 60 total
Declined: Unity health, UPMC, Penn state, Emory, Grand Strand, LSU-Shreveport, University of Mississippi, Texas Tech
Rejected: Carolinas, University of Missouri, all of the University of Tennessee locations, JPS. Ghosted by many more
 
Applicant Summary
Board scores: 200s/230s
EM rotation grades: High Pass/Pass (P/F only)/Pass (P/F only)
AOA: No
Medical school region: Southeast
Anything that made you more competitive: Research experience, Publication, EMS experience

Main considerations in creating this ROL: Fit, Spouse's preferences (namely location)

1) SC -- Greenville Health System
(+) Impressed with this program for it being so new. Seems like the leadership is dedicated to making it a solid place to train by bringing in faculty from top name places that are interested in teaching residents. Great small city with lots of charm and outdoor activities
(--) Newer program that hasn't graduated a class. Didn't vibe with a few residents, although most seem like they're great. EM alternates head of the bed with surgery during traumas.

2) TX -- TX A&M Scott & White Memorial Hospital
(+) Dr. Drigalla is the man. S&W seems like a solid place to train good, competent community docs. Lots of Pediatric EM exposure. Good cost of living.
(--) Location, 12s, lack of job opportunities for my spouse

3) SC -- Palmetto Health Richland
(+) Dr. Cook is also the man. I felt like I got along best with the residents here compared with anyone else. Great regional reputation with a robust ultrasound curriculum and global health focus. Patients in Columbia are sick as ****.
(--) Location, 12s

4) OK -- University of Oklahoma College of Medicine/Tulsa
(+) Had great interactions with faculty and residents. It's the only place I looked that has a dedicated burn center, so it would be nice to get that exposure in residency. The residents here seemed to be a close-knit group that does a lot together outside of the ED. Tulsa seems like a fun place to live with lots of activities.
(--) Not a level one trauma center, have to travel to OKC for peds rotation

5) AR -- University of Arkansas
(+) Surprised at how much I enjoyed Little Rock. Residents seem nice and down to earth. UAMS has a good deal of pathology being the major hospital for the state of Arkansas.
(--) ED seemed smaller than other places. Lots of other specialties training here, so not as much unopposed patient care/procedures as some of the other programs where I interviewed.

6) VA -- Carilion Clinic - Virginia Tech Carilion Emergency Medicine Residency
(+) Roanoke is a great town for outdoor activities. Lots of medically sick patients.
(--) Less urban patient population, didn't have the best interactions with the PD or some of the residents.



Anything to add? Wasn't able to overcome the low Step 1 as well as I would have liked. Wished I would have applied to more programs than 46. Fingers crossed that everyone hears good news come Match Week!
 
Applicant Summary
Board scores: 250s/260s
EM rotation grades: Honors/High Pass/Pass (P/F only)
AOA: Yes
Medical school region: Northeast
Anything that made you more competitive: significant research before med school, i dont know maybe some extracurriculars, balding but owning it

Main considerations in creating this ROL: Location (west coast>east coast; SoCal>rest of west coast) > fit > QOL > likely incorrect perception of quality of training > prestige (although no doubt prestige factored in subconsciously). Small preference for county over academic (didn't apply to any community places). Also small preference for shorter shifts

I bought into the idea early on that every program will train you to be a badass if you put your back into it, so all I began to focus on was how happy I think I would be at a programs. This mostly turned into how well I thought i would fit in with the residents and faculty and the QOL of the residents. Aka: some programs that work you to the bone took a tumble

Also had non-med student SO input on the list, SO wanted west coast

1) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pros: I loved everything about this place. Residents were some of the most fun on the trail and clearly loved each other but also took the time to hang with the applicants. Faculty equally awesome and PD was great. Living on the beach would be amazing. Incredible county training and pathology. I loved the idea of teaching rounds, seemed like an hour bookending each shift was exactly the amount of time I could stay focused and actually learn things. Beautiful and new ED where you are tripping over ultrasounds. All the warm and fuzzies

Cons: 4th year just seemed like a repeat of 3rd year, I really couldnt pick out any differences clinically. Lack of resources for things outside of clinical training (such as global health, etc). Limited elective time particularly for a 4 year program. Standard LA problems (traffic and COL). Put on weight during interview season and have no motivation to lose it --> beach self-consciousness

2) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Pros: I honestly feel just as strongly about this place as I do about Harbor, and would be equally happy to match at either. Something just had to go first. Probably the most fun group of residents and faculty I met on the trail, they all seemed to genuinely love being there. I interviewed towards the tail end of the season and they were still so fired up to meet the applicants. The 50:50 academic:county split is pretty perfect for me since I am kind of hovering around an academic career but kind of want county training. Tons of elective time during fourth year to help make these decisions. RR is a gorgeous hospital although the ED itself was surprisingly great but not amazing. Another perfect location to live in. 12s all 4 year allows for more days to get botox and tan

Cons: The trauma training seemed pretty so-so since OV isnt a trauma center and RR is a bougie trauma center. Traffic getting to and from OV could be miserable although apparently they redesigned the shift schedule to help avoid traffic and its been working. 12s all 4 years. Otherwise nothing, would be so happy to end up here

3) CA -- University of California Irvine Medical Center
Pros: I could feel my BP rising as the PD gave her intro talk and presentation. I was really feeling her energy and passion for training residents and felt that she would be awesome to work with. Really talk up how each resident sees 2k/pts/year, great trauma experience (PD says its actually "too much" trauma), lots of peds, solid work life balance. Residents extremely friendly and chill and seem to genuinely love the program. 3 years with a great sell on why 4 years is unnecessary. Social in long beach was at an awesome spot and was pumped when multiple residents told me they live a few blocks away.

Cons: As mentioned, would rather live in LA than live in LA-ish. Small class size seemed a bit concerning, probably hard to hang out off shift with so few people and even harder to trade shifts. Limited resourches outside of clinical training

Honestly if this program were sitting in actual LA it wouldve challenged for number 1. I went to this interview thinking it would sit in the middle to low end of my list and was blown away. I got just as many warm and fuzzies from it as I did from the top 2, and love the 3 years, but dropped it just a little bit based off location alone

4) WA -- University of Washington Emergency Medicine Residency Program
Pros: Based on what I've read on SDN, I am one of the rare people who actually liked interviewing at UW. If youre a future applicant, take my review amongst all the others obviously, but personally I loved it here. Harborview seemed like an incredible place to train, with UW providing the ivory tower training and the complex patients that come with that. Lots of unique opportunities, particularly with EMS, because it is the only trauma center for 5 (FIVE) states in the pacific northwest. You'd see everything from MVAs to GSWs to avalanche disasters to tractor-based emergencies. Social was one of the most fun on the trail, and had great interviews with all of the faculty (I guess some people had bad interviews with the PD? I thought she was awesome). Seattle would be great to live in. Given that I may want an academic career, training there and potentially staying on as faculty or APD seemed like it could be an amazing opportunity to build a program that I genuinely believe will be the next powerhouse. Also, since they are a new program (began in 2013), seemed like they were very open to feedback from residents and allowed you to craft unique opportunities for yourself during elective time.

Cons: Residents for sure cooler than me but somebody has to bring down the average. Like many have mentioned before, the program is new and is still going through some bumps in their training. Turf battles that get talked about a bunch are probably pretty overstated but I'm sure there is a kernel of truth to them. New program also means low amount of alumni which could affect job hunting down the road. Harborview kind of an old school ED without some of the bells and whistles of the UCLAs. 1st year seemed like a real grind. Had some questionable off service rotations. 3 weeks of vacation. Very low salary for the COL of Seattle

Notes: how does anyone survive a level 1 trauma in Alaska long enough to make it to Seattle? Those are some damn good EMTs

5) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: great academic program with all the resources that come from the Stanford name. Probably the most beautiful hospital in the country; I havent seen anywhere close to all of the hospitals in the country but feel pretty comfortable making that claim. The children's hospital is closer to a science museum than a healthcare facility. And apparently the beautiful af ED is old and decrepit so they're building a brand new one that'll likely rival staying at the four seasons. Seemed like anything you would want from residency you could get from this place, with every extracurricular elective opportunity available. New 4th year, exciting to be able to essentially redesign one of the best academic EM programs in the county while you are a resident. Would be really good training if trying to become an APD or PD down the road. Highest salary in the nation. Really nice shift schedule (~5 10s a week is pretty perfect in my opinion)

Cons: potentially would have ranked this much higher if I hadnt heard from some of the residents how much they want more county training, which is currently only 10% of their time, and think that it would really benefit their training. Seemed like a big red flag that multiple felt that way. Crazy COL in area and kind of so so on wanting to live in Palo Alto, didnt feel like a lot was going on there. Residents were great but didnt vibe with them quite as much as I did with residents at places 1-4. 3 weeks of vacation

6) NY -- Mount Sinai School of Medicine - New York
Pros: Another place I loved. One of the most fun socials on the trail, residents all clearly loved chilling with each other and made time every week to do so. Big class size (25) really helps with that. Great diversity of training between academic, county and community all within one program. Elmhurst seemed like a really unique and crazy place to work. They stressed all day about how they are looking to train the next leaders of EM which I thought seemed awesome, definitely felt like they will help you get to where you want to go right after residency. Dr. Shah is the man

Cons: Dr. Shah is leaving. Seemed liked they worked a lot of really hard 12s. Sinai's ED is about a fifth the size that it actually should be, you'd genuinely trip over patients. Commuting between sites seemed kind of miserable. Standard endemic NYC ED issues (poor nursing, pushing patients, placing IVs, poop everywhere).

7) PA -- Temple University School of Medicine
Pros: I loved everything about this place. The residents were amazing, Dr. Ufberg (PD) was hilarious, rest of faculty were awesome. Spent my entire interview with Dr. Ufberg riffing about concerts, after 20 minutes we had yet to discuss anything remotely related to medicine or the program and I loved it. Crazy trauma, they get 50% penetrating trauma which is almost hard to believe but it is north philly. Loved how due to the circadian rhythm scheduling, you end up working with the same group of residents for a month at a time. Seemed like an awesome team based way to learn EM. 3 years. Very few off service rotations, most of your time is in the ED. Philly has amazing COL

Cons: Purely based on location, if this program was on the west coast it wouldve battled for number 1. Just dont really want to live in philly but training here would be probably make it worth it. Didnt love the circadian rhythm scheduling but think I could get used to it.

Honestly if I open the envelope and see this program I'd still be ecstatic. Highly recommend that anyone who wants to live on the east coast should apply to this program

8) IL -- John H. Stroger, Jr. Hospital of Cook County
Pros: Another super fun social with residents who I definitely think I could vibe with for 4 years. Faculty were pretty chill too and had some really fun interviews. Awesome county training with guaranteed badass status awaiting you at the end of the road. Graduated responsibility in the ED means that you will become that badass at a reasonable rate. Gorgeous ED, particularly for such a county place. Theres no way you could get better trauma training anywhere else

Cons: Chicago seems awesome but I dont know a ton about it nor do I have many ties, and me and SO are both soft and don't want to be cold. 2 medicine floor months? 4th year seemed super unnecessary, and in general there was just a lot of off service. Being a purely county place with lots of big academic places down the street, you miss some of those crazy complicated quadruple organ transplant type patients

9) MA -- Harvard Affiliated Emergency Medicine Residency at Beth Israel Deaconess
Pros: Really solid clinical curriculum. Get thrown to the wolves during PGY2 and 3, you are essentially an attending as a PGY3 as you cover the entire ED and are responsible for knowing and signing out each patient. The attendings are there for backup. 3+1 format is pretty cool, seems like you are basically guaranteed placement where you already live to do any fellowship you want while making 2-3x what you would doing a standard fellowship. Residents and faculty pretty chill. I was into the PD's stoic yet lighthearted thing he had going on.

Cons: Not super into Boston but have quite a few ties there so could definitely make it fun for 3 years. Other than that not much else, another place that probably would have been ranked much higher if in a different location. Could use more county training but the training at BI seemed so strong that maybe this isnt actually true. Potentially not enough graduated responsibility?

Notes: No sign of the Harvard pretension, the name literally didnt get mentioned once by faculty or residents.

10) CA -- Los Angeles County/University of Southern California Medical Center
Pros: The craziest clinical training in the country with guaranteed badassery awaiting you after 4 years. Loved the social mission of the place. Combo of alumni network out the wazoo and one of legendary names in EM means that any opportunity you want is available upon graduation. Dedicated team based trauma seemed awesome. Jail ED would be a really unique experience to help a truly underserved patient pop while getting valuable community ED experience in a county ED.

Cons: The same as everyone else says. So many 12s all 4 years, and the 12s themselves seemed brutal. Adding two residents this year but no one really seems to know how that is going to affect the schedule. Definitely unnecessary 4th year. Potentially thrown to the wolves too much, particularly in the jail ED where you begin what is essentially solo coverage (the attending is 5-10 minutes away) as a PGY 1.5. East LA not as much fun as west LA in my opinion

12) CA -- University of California Davis
Pros: Really liked the clinical training at this program. Felt like essentially a county program at an academic institution, with opportunities to train at multiple sites around the area. Really nice ED. Liked how the PD just chilled with us all day and shot the ****. Probably the best shift schedule that I saw on the trail; they do 10s but with 2 hours of overlap at the end of your shift, so its really 8+2. Plenty of time to clean up loose ends, and residents said they sometimes even leave before the 10 is over. 3 years

Cons: Dropped this purely based off of social and location issues. Only a few residents showed up to the social the night before, and even fewer showed up to the interview day lunch. Based on the two and conversations with the residents I did meet, it definitely felt like the residents dont hang out all that much. I don't think I know anyone who has even been to Sacramento so would definitely need some new friends if I got there, and wasnt confident that that would be easy to do. Otherwise, not much here about the program itself I didnt like, just wasnt sure I could be happy here

13) NY -- SUNY Downstate/Kings County Hospital
Pros: Awesome training in the middle of Brooklyn, which I would love to live in. Probably the most fun social on the trail, really started to get rowdy towards the end which i was very into. Clearly amazing training and incredibly diverse pathology being in the heart of NYC. Work very, very hard but not an overbearing shift schedule; 12 hour shifts for PGY 1 (18) and PGY 2 (17), 8 hour shifts as PGY 3-4 + 12 hour shifts on the weekends (roughly 4 per month).

Cons: Had an extremely offputting interview with the PD that I just couldnt shake off me for the rest of the day. I was told that she was cold before going in (which was a red flag in itself), but still was not prepared for the ice storm that awaited me. It was probably just a bad interaction and that she is actually great, but I just wasnt sure that Id be happy training with her for 4 years. In general didnt vibe with the faculty a ton. All the NYC ED issues mentioned above. Terrible EMR.

Only put it this high because I vibed so much with every resident I met and felt I would fit in really well with them. And love Brooklyn

14) DC -- Georgetown University Hospital/Washington Hospital Center
Pros: Solid 3 year program in a fun city. Residents seemed happy and had a good life in DC. Cool and unique opportunities (well unique except for GW) to get involved in health policy and get to go to the white house. 1:1 resident:attending ratio on each shift all 3 years. Get to pick up any patient at any time

Cons: No major cons, just didnt get any great feels from being there. Residents werent stoked about the program which was kind of a red flag since they usually pack a lot of energy. Would rather live in NYC than DC if I'm gonna be on the east coast.

15) DC -- George Washington University
Pros: Very academic. They really pride themselves on training EM docs who are going to do more than just practice EM. Same interesting ways to get involved in health policy that georgetown offers, but expanded upon since you have an extra year of time to do things.

Cons: I wasnt sold on their clinicals in general, and during the tour the PGY3 resident said that he/she had only tubed 2 pts, which definitely seemed like a red flag. Only program i went to where they talked about their nonclinical stuff (research, pgy4 mini fellowships, etc) more than they talked about their clinical training. No warm and fuzzies, but thats just me.

Met other people on the trail who really liked this place and georgetown, perhaps I subconsciously just am not as into DC as I thought I was

16) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
Pros: Awesome training with an incredible patient pop that you can provide care for for four years. No doubt that you would come out a badass ready to handle anything. Really diverse and fun resident group, and great faculty from top to bottom. Jacobi and Monte are nuts in a mostly good way

Cons: Jacobi and Monte seem to be sometimes nuts in a kind of bad way. Monte in particularly has a infamously chaotic and overcrowded ED that would no doubt provide awesome training but may get exhausting over 4 years. A little too county in the same vein as USC and kings county. All the NYC ED issues and then some. No interest in living in the Bronx but seemed pretty possible to live on the upper east side and commute to work.

17) NY -- New York Presbyterian Hospital
Pros: Very academic heavy. Tout how many of their graduates go into academic roles including directly into APD positions. Two different sites give you an academic-academic (Cornell) and an academic-county experience (Columbia). Patient population spans the entire spectrum from uninsured to overinsured. Cornell is a gorgeous hospital, Columbia pretty nice too.

Cons: Commuting between the two sites seems like a pain, residents say they leave an hour and a half before the shift starts to get to the other site (sounded like half lived at Columbia and half at Cornell). Didnt get a chance to go to the social, but of the residents I met during interview day, only one seemed genuinely excited about the program. Heard through the grapevine that some residents werent too happy there, could be false but I heard it from enough people that it must be somewhat true. 4th year didnt seem to be used all that well, particularly for an academic place. NYC ED issues but less so than the ones listed above. Only ranked it above the next program because I figured if I ended up here it would probably open some career doors given its name

18) NY -- New York Methodist Hospital
Pros: Residents were awesome, faculty clearly very engaged in making the program better. No doubt about clinical training. Only 1 month of elective time, but lots of fellowships available. REALLY INTO ULTRASOUND, and you have the opportunity to get credentialed as a point of care ultrasound expert while training (which makes your ultrasounds "official" aka equivalent to a radiologists. 3 years

Cons: Few academic, research, global health, etc opportunities due to only 1 month of elective time. ED was the least overcrowded id seen in NYC, but still overcrowded compared to everywhere else. Seemed to have the fewest of the NYC EM endemic issues compared to other programs. Just no real feels about the place.

19) CO -- Denver Health
Pros: Badass powerhouse in a pretty cool city with all the history behind it. You work your ass off but you reap the rewards of being a clinical monster for the rest of your career. Denver was a pretty gorgeous hospital. Residents were awesome. Denver vibe is great. PD is amazing and would love to work with her. Rocking a beanie year round would help hide my bald spot

Cons: Yup I'm that SDN stereotype. Was definitely scared off by how hard they worked, and was even more scared off by how much every resident seemed to be proud of how hard they work. I'm just not that person and didnt think I'd fit in at all or be happy. That being said, if you are that person, then there is no doubt that this would be an absolutely fantastic program to train it. Never got a handle on how many shifts they actually work, every resident seemed to say something different. I heard anywhere from 24 per 28 days (+ conference) and no golden weekends ever to 21 per month and skiing after every shift. Also Denver people are way cooler than I am


Anything else to add? I'm sure I'll get some hate for going on a lot of interviews but I'd honestly recommend to future applicants to go on a bunch. I made a pre-list prior to interview season of what I assumed my list was going to look just for curiosity's sake, then didnt look at it again until the end and thankfully forgot where I put places on it. It bears no resemblance to what my list ended up looking like (for instance, I thought UC Irvine was gonna be number 11, not number 3 where it ended up). Places surprise you, and throughout the process you will also develop a better understanding of what you are looking for. Apply broadly, go on a variety of types of interviews, and keep your eyes open. However, I will say that once you do know what you are looking for, immediately cancel and withdraw to help out others. Also maybe go on a couple less than me so you end up less tired and broke

These lists were super helpful to me so I tried to pay it forward, hope it helped!

Applied to: All of the above plus all of the below. Total of 30
Declined: New York Medical College, New York Presbyterian Queens, State University of New York - Stony Brook
Interviewed: All ranked
Withdrew prior to hearing from: None
Rejected: Alameda Health System - Highland Hospital, Boston Medical Center (ghosted), Hofstra Northwell (ghosted), Harvard Associated Emergency Medicine Residency - Mass General Hospital (ghosted), New York University (rejected but only after letter on interest), Oregon Health Sciences University, University of California - San Diego (ghosted), University of California - San Francisco (never got off waitlist), Mount Sinai - Saint Lukes Roosevelt (ghosted)
 
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Applicant Summary:
Board scores: 220s/240s
EM rotation grades: Honors/Honors/Honors
AOA: No
Medical school region: Southeast
Anything that made you more competitive: Nontraditional with prior work experience, good med school, but from my med school CV no, not really.

Main considerations in creating this ROL: Location, wife's preferences/job opportunities, 3 years, program leadership, work/life balance, resident vibes. The longer the interview trail went on the more I felt the differences in curriculums were minimal. I feel like your ability to come out of residency a solid clinician is as much about you as it is about where you train.

1) TX -- University of Texas at Austin Dell Medical School
Austin is an awesome place, and by far my wife's favorite city in the country. She has an outstanding job offer there already. We love the warm weather, the food, the music... The program has a great PD in Dr. Berger, it is clear he would bend over backwards for his residents. Their shift schedule, salary and benefits are I believe the best I encountered on the trail. No state income tax. Tort reform. I really like the 1 on 1 attending coverage. Program on the newer side but already quite competitive and on what seems like a strong upward trajectory. New medical school there dumping resources in, will provide a good mix of county/academic. Alumni base not huge yet but their graduates have gone on to some very good fellowships/competitive job locations so I don't believe this to be a hindrance. I get the concern about CMG's but I experienced the working and teaching environment here first hand and it was nothing short of fantastic.
Ultimately this was the place my wife and I saw ourselves being the happiest for three years.

2) TN -- Vanderbilt University
Love Nashville- super fun town with great bars, restaurant and music scene. Have some friends there. Good job opportunities for my wife. Vanderbilt as a program was very impressive- the place oozes money. Very established name in EM that would also impress my grandma. Really liked their new PD as well as my other interviewers. Would be nice for someone like Dr. Slovis to pick up that phone for you. Only con i can think of is perhaps a bit too academic, consult heavy because of other super strong residencies in house? Went back and forth with this for my #1 spot, in the end it was like a 51/49 split. Would be super super happy here. At the end of the day I'm probably going to be working in the community, so the "prestige" factor of my residency not as important. Once I let that go and got over my ego at even interviewing here I realized it belonged at #2.

3) NC -- University of North Carolina
Very solid program, have spent a lot of time here and think everyone involved is fantastic. Sat in on one of their conferences and loved the family atmosphere, big names in EM joking around on first name basis with new interns. I think the site split between UNC and wakemed is great, just a little unfortunate it adds a commute. I've been doing the commute thing for too long now so this does play a role in my decision making. Love the triangle but ready for something a little more new.

4) NC -- Carolinas Medical Center
Obviously very strong program, fantastic pedigree, influential alumni base. Would open doors for you if you needed it. I've spent a lot of time in Charlotte, it's cool enough (and getting better) but doesn't exactly have that "it" factor for me. Residents some of the closest and most fun I met anywhere, they really seem to enjoy each others company. Would be thrilled to match here, but ultimately the search for something new in terms of location kept it from being higher.

5) VA -- Virginia Commonwealth University (VCU)
Richmond is a really really cool city. Has that gritty, artsy feel and has an awesome restaurant and bar/brewery scene. Within an hour or two can be either in the mountains or at the beach. I loved their pre-interview social and the residents seemed super tight knit. Dr. Moll is the man, like I want to be friends with him. Seems like they're doing a lot of cool stuff in their department. Would have probably competed for #1 were I single, but my wife had stronger location/job preferences for the programs higher on my list.

6) SC -- Medical University of South Carolina (MUSC)
Really love Charleston, have some good friends there. Could live close to the beach/water activities. Great weather, food & drink scene. Really loved their PD, felt like leadership & residents were really family. Six seemed like a small class size and was happy to find they're expanding to ten. The concerns others have had about volume/acuity seem like they might be true, but it didn't really factor into my ranking. At the end of the day lack of job opportunities for my wife was the biggest concern- in Charleston if you don't work in healthcare or tourism/hospitality you're extremely limited.

7) SC -- Greenville Health System
Very new program, haven't graduated a class yet but I have no doubt they'll do just fine. Strong program leadership- everyone felt very invested in the residency succeeding. Sim lab was cool. Liked Greenville a lot more than I expected- young, vibrant, walkable downtown. Close to lots of outdoorsy stuff, close to family we have in Charlotte. Vibed with residents at the social better than maybe any other program. Very limited job opportunities for my wife in her sector, unfortunately.

8) FL -- University of South Florida
Liked the PD a lot, seems like they've made some positive changes in recent years in terms of work/life balance. Residents I interviewed with were chill. Tampa seems cool and like it's in the midst of a nice downtown resurgence, although if we lived there we'd want to live on the beach and then you've got a 30+ minute commute.

9) CA -- University of California San Diego
Absolutely love San Diego (duh), really liked the faculty I interviewed with as well as the residents I met. At the end of the day it's too far from family... we'll be having kids during residency and the flight distance and time change makes visits too time consuming and costly.

10) IL -- McGaw Medical Center of Northwestern University
Great program, very academic. I thought they sold their 4th year well. I liked their PD a lot. Would have been happy to train here were it not in Chicago- it's a hard "no" from my wife (we don't do cold weather well).

Anything else to add? All about those SLOEs, I didn't have much else that made me competitive besides clinical performance and interpersonal interactions (and I love that that is what EM values). Interview trail was cool but exhausting and expensive.

Definitely over applied, it was hard to gauge how competitive I was with below average step scores and blinded SLOEs. Figured for some assurance what was a few hundred dollars more at this point in the game?

Applied to: The above plus 60 more.
Declined: Denver, UTSW, UTSA, UT Houston, Baylor, UCLA RR, Utah, Mt. Sinai SLR, Brooklyn hospital, New Mexico, Drexel, UMKC, UNLV, Georgetown, NY Methodist, Palmetto health, George Washington, Rush, Loyola, U Penn, Kentucky, UT Nashville, Eastern VA, LSU Baton Rouge, Maricopa, Aventura, UF Jacksonville, Carilion clinic, Mt. Sinai miami, MC of Georgia, UAB, Florida atlantic, Allegheny
Interviewed: The 10 above.
Rejected: Highland, Kaiser SD, Temple, OHSU, U of Chicago, FSU, UC Davis, U. Illinois Chicago. Waitlisted at Stanford, UCSF, LAC/USC, and UPMC
 
***This is an update to post #56.****

Applicant summary
Board scores: 270s/270s
EM rotation grades: High Pass/Honors
AOA: Yes
Medical school region: Midwest
Anything else that made you more competitive: GHHS, lots of extracurriculars, some med school awards.

Main considerations in creating this ROL: Badass clinical training first and foremost, prefer ED team to take on an active role in trauma procedures and act as trauma leaders. Want the ED to have power and autonomy within the hospital system. Would prefer academic county hospital or truly de facto county population at academic center. Want enough elective time to explore the specialty and create a “niche” with interests in ultrasound, education, and global health. Location is secondary and West Coast >>> everywhere else because of weather, water, mountains, and vibes. Anything not west coast will become much more undesirable with increased COL and traffic. Would like to have regular contact with Spanish speaking patients, but this is also secondary to overall program strength (more important than location though).

I made this list mostly for myself as a stream-of-consciousness exercise, so I know I get super-detailed and my ramblings may come off as the ignorant musings of a neurotic, know-nothing M4, but I hope somebody next year finds it useful. Was hesitant about posting because of this, but haters gonna hate man.

1) CA -- Los Angeles County - Harbor-UCLA Medical Center
Great training in a county hospital that serves a majority of Hispanic patients. With the amount of Spanish at Harbor I won’t need to do Global Health rotations (which is great because I can’t). Was really impressed by the senior residents and attendings during conference. Seems like the most livable area of LA, with lower COL and less commuting than West LA. Also, 8-10 hour shifts with built in teaching rounds seems like a great schedule. Heard rumors about this place being broke, but the free food is great and overall I thought residents were fairly compensated, especially with new $4,000 housing subsidy and bilingual bonus. While the hospital is lacking resources (no Dragon), I think it’s worth it for the social mission which really resonated with me. Wish I would have had some face-time with the PD, but loved the APD from Brooklyn so much it’s no biggie.

2) TN -- Vanderbilt University
SLOVIS, EDUCATION, 3+1. Need I say more? Really though, thought this place would be too academic and hands-off, but all the seniors were super confident and very sure that 3 years was more than enough to make them badass doctors. Only place that sold 3 years other than the whole “$250,000 mistake” argument, which I appreciated. Program so invested in the residents that you can’t lay low here, they will make you the best you can be. Great to have Slovis make that call to get you wherever you want to go. Not a fan of the south, but I can get down with Nashville for the hot chicken and bachelorette parties.

3) AZ -- Maricopa Medical Center
Classic county, bunch of Spanish speakers, best night shift schedule, and an enthusiastic PD who seems to have really put this program on a track to success (revised the curriculum to be much stronger and coordinating new partnership with Creighton University and Mayo in Phoenix). Senior residents exuded clinical confidence. 3 elective months is GREAT for a 3-year program. Loved Phoenix, great outdoor access and really cool Hispanic parts of town. Beautiful women in Scottsdale (but probably out of my league). Unfortunately, I don’t think the academic resources are where I would like them to be (I suck at research and need HELP to do it) and the reputation just isn’t as strong as a lot of the programs below, but for reasons listed above I know I would be very, very happy at this program which makes up for all of that (is that what “fit” is?). Plus, fellowship placement this year was at places I’d love to go so career-wise I don’t think this would limit me.

4) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Great county/academic split and more money than Harbor. However, West LA just seemed too ritzy to me with worse commute times. Add that to 12 hour shifts and the adjustment to lifestyle would be rough for me coming from the Midwest. Cool FOAMed/EMRAP opportunities and strong global health. Pros clinically is getting to run the department and learn how to move-the-meat. The senior giving my tour said they are the most recruited LA program since the programs with only county locations have no financial incentive to see more patients. Makes sense to me? Would like OV to be a trauma center, and for RR to have more penetrating, but I think this wouldn’t be a huge deal.

5) OH -- University of Cincinnati College of Medicine
Think I will get the best training out of my top 5, but having little to no Hispanic population and undesirable location (my Lord it’s pretty much Kentucky) knocked it down here. Would still be super stoked to match though. Learn autonomy and put your skills to the test as a flight doc starting in R2 year. Opportunities for “paid elective time” flying as well. Work with SWAT teams and serve on the presidential detail/meet famous people. Great clinical training overall, but watching a cricothyrotomy performed in a dead-silent resus room during the tour probably biased me. Curriculum is well-thought out and R3 year sounds like the best job ever. De facto county at an academic center where EM is strong relative to other residencies (which are neither too strong nor too weak) is a plus too. 6.5 months of elective time will give me good Spanish exposure with global health work. Great alumni network and legacy. Tbh if I wasn’t trying to leave the Midwest and if Cincinnati had more Hispanics, I would put this number 1 or 2.

6) MN -- Hennepin County Medical Center
The most cowboy county program (talking about not consulting, yes I know there is graded responsibility) and a research powerhouse. Innovative clinical training and beautiful hyperbaric chamber. STAB rooms were awesome and I would be so pumped to run a TEE during a code. So many ultrasounds nobody could give me an accurate count. Don’t think any program compares clinically. Also, more Hispanic patients than I thought. However, the 1.5 elective months made this program seem like too much of a sprint for me to figure out if I want to do a fellowship and I am unsure if I could handle the cold and snow (gotta say this didn’t become a factor until mid-January). Also, while EM is king of the hospital I worry about the strength of off-service rotations the way I do about Carolinas and Maricopa.

7) NC -- Carolinas Medical Center
Great clinical training, strong ultrasound, cool global health opportunities and awesome EM reputation with lots of academic resources. Hospital seems to rain money down on the residents. Sounds like legit de facto county and only level 1 trauma center in the area. Was pleasantly surprised when one resident said 20-30% of the patients are Hispanic and that he speaks Spanish at least once a shift. Also have an established ultrasound education program in Guatemala with combines all 3 of my academic interests. It’s great that EM is a relatively strong residency in the hospital, but kinda makes me worried about off-service rotations, got the sense that EM residents are expected to carry the load on these services. Vacation schedule is also kinda weird. Don’t like the south and didn’t like Charlotte as much as Nashville Too humid in the summer – taking a gamble and assuming I’d rather freeze to death in Minnesota. Big fan of 3 months of electives.

8) IL -- McGaw Medical Center of Northwestern University
Great name and academic/EM powerhouse. Pumps out leaders. Clinically strong, however I hesitate to believe that they’re county-esque as Bailitz sells it. Trauma at Cook and ED in Gary, Indiana make up for that I think. Great to see the Chair so invested in the program, you can go anywhere from here. 9-10 months of ICU probably would make me a better doctor, but sounds intolerable especially when you get only 3 or so months of electives (in a 4-year program!). I know Chicago is awesome by most people’s standards, but don’t think it’s worth the COL and traffic, especially when commuting to Gary (no mountains or good weather, felt like a Midwestern NYC knock-off with ****tier pizza). But, I have friends in Chicago unlike most of these other cities and few programs can rival the network, resources, and opportunities of this program.

9) WA -- University of Washington Emergency Medicine Residency Program
Probably some great clinical training with academic/county split and great trauma exposure with unique flight experience, but had a pretty negative experience with the Program Director (sounds like I’m not the only one). Besides that, have concerns about inflexibility with elective time by having to pick a track (and giving up 3/4 electives to have a substantive flight experience) and an academic center just too damn quaternary for my liking. Even if you apply to the Global Health track you are only guaranteed funding for one elective abroad. Residents seemed a little overworked (rumors of turf wars and problems with off-service rotations seem true). Gotta say I love Seattle though, so in spite of the negatives I think location and quality of training would be worth it, but can’t say I’m not taking a risk here.

10) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
This program was way higher on my list (number 1 for a while) until I awoke from the Harvard spell. Great that you got to meet with both chairs, I enjoy when they show commitment to the program, but got the sense that it’s more about networking, connections, and resources at this program than clinical strength. Also kinda threw me off that every interviewer wore a suit (a little too conservative/formal of a culture for me… but maybe they decided to suffer with us?). At first bought into the whole MGH is county but have since found this claim dubious. Sounds like you’ll just get a bunch of differentiated patients at Brigham that require a ton of consults. Wish they had more community experience and exposure to “bread and butter” EM. Boston is TOO DAMN EXPENSIVE and if I am going to pay that much to live somewhere I’d rather be in Southern California, not New England. However, the Harvard spell lingers and I can’t deny the resources and network (and ego trip) that this could provide, hence its position. Also, to be fair they had an alumnus/a go into a faculty position at USC so how lacking clinically could it be??

11) MO -- Washington University St. Louis/Barnes-Jewish Hospital
Biggest surprise of the interview trail, had an advisor suggest dropping this interview when I asked, but my god they are awesome. Gun and knife club (average of 4 penetrating traumas/day) and de facto county at an academic powerhouse institution. PD was awesome and had us grab a beer from the fridge in the resident lounge for his wrap-up talk. Trauma exposure is so good they don’t even do a dedicated trauma rotation (which saves a lot of scut-work). Had a resident quote 15 lines and a couple chest tubes their first month working in the ED as an intern. Barnes-Jewish hospital is great, off-service rotations would be legit, but I also got the sense that EM is still well-respected. One month of peds floor sounds awful, however. Wish they had more Hispanics in Missouri, but once again, I can dedicate my elective time to global health to make up for it. Unfortunately, I just had a hang-up about putting this place above the “legendary” programs and/or ones in cooler locations (also the fact that they’re a division and not a department bugs me), hence its position.

12) TX -- UT Southwestern Medical Center - Dallas
Best pre-interview dinner and felt I could really bro out with the residents, loved the margarita machine. However, seemed like the culture of the program was to get out in 3 years and make $$$ in the community in Texas with a free vacation to New Zealand in the process (although there are worse career paths for sure). Just looking for something more academic in culture and though it’s county, seems too consult heavy and ED team only gets airway in trauma. Did not get the sense that EM is well respected in the hospital (but can’t say this was not influenced by unsubstantiated SDN rumors). Lots of Spanish which would make up for some of the negatives I’ve mentioned. Texas is not my cup of tea and Dallas seemed like a cultureless, corporate city, but hey it’s pretty cheap.

13) CA -- University of California San Diego
Location, location, location. However, huge negative on how they run trauma, won’t even get airway unless on a trauma rotation. Decent elective time with flexibility to go on pretty cool global health rotations, de facto county, and being right on the border with Mexico is pretty enticing. Lots of Spanish obviously and more livable than LA. Nice variety of sites, but spending so little time at El Centro when it was the clear favorite of residents is a bummer. Good resources to whip me into shape for a possible career in academics, but can’t shake the feeling that location and academic resources make up for clinical shortcomings. Flight program might compensate for this a bit, but at the time it just didn’t stand out the way Cincinnati’s did.

14) OR -- Oregon Health and Science University
Overall solid, but nothings stands out with this program. Great people and admirable focus on education though. Quite a few community rotations to make up for my concerns about the main hospital clinically, but overall a little too academic with lower trauma exposure than I would like. Cool rural medicine rotation in Astoria and community peds rotation. Little Spanish exposure and short on elective time. Bummer, because Portland would probably be my favorite location out of all these programs.

15) PA -- University of Pittsburgh Medical Center
Came in biased against this program unfortunately (heard rumors about residents being miserable and overworked), but the residents seemed happy enough. However, a resident listed ultrasound and global health when asked about program weaknesses (the two fellowships I would consider). Jeeps would provide a unique experience, but the amount they drove us around in them was just a little much (tried to sell it too hard). Pittsburgh is a uniquely depressing city (I was born there, grew up in PA), with little to no Hispanics and not enough elective time to make up for it with rotations abroad. On the plus side, pretty sure it’s great clinical training and I would love being able to take my dad to Steelers games and work in the hospital I was born in.

Anything else to add?I posted a few weeks back with an abbreviated list to avoid being "ID'd."

Feel really fortunate to have gotten these interviews and would be happy anywhere (especially at programs 1-8).

Midway through the interview season I had the academic powerhouses in sexy locations with big names inside and/or outside of EM highest on my list (eg HAEMR). However, interviewing at Cincinnati in January really rocked my world and made me realize I want to be where I’ll get excellent clinical training and where the ED holds power in the hospital system, and the results are this rank list. Yes, you will get good training anywhere, but I believe there are certain programs where you get GREAT training, and I prioritized those. I just wanna be a BADASS EM COWBOY.

Best piece of advice I got (albeit too late) was to talk to the people in the class ahead of you who already went through the interview process to figure out if programs are good or not. They know much better than many of your advisors and I know this because I got some shaky advice about programs from faculty at my home institution. ALSO, fly Southwest (free cancellation, 2 free checked bags – and midway through iv season they mailed me vouchers for free drinks) and invest in a travel steamer.

Declined: Penn State UT Houston University of Arizona South Campus UNLV Temple Mercy Saint Vincent’s Cook County UC Davis University of Maryland Jackson Memorial
Withdrew prior to hearing back from: Baylor University of Arizona Main Campus UC Irvine
Rejected: Denver LA County/USC Alameda/Highland Emory Beth Israel UCSF Fresno - Fresno hurt the most, still not over it
 
Applicant Summary
Board scores: 220s/240s
EM rotation grades: Honors/Pass/Pass/Pass
AOA: No
Medical school region: Southeast

Main considerations in creating this ROL: Geography

1) FL -- University of Florida - Jacksonville
2) FL -- Florida Atlantic University
3) FL -- Mount Sinai Medical Center/Miami
4) SC -- Palmetto Health Richland
5) FL -- University of Central Florida/HCA GME Consortium of Greater Orlando
6) FL -- University of Florida - Gainesville
7) LA -- Louisiana State University - Baton Rouge
8) FL -- Aventura Hospital & Medical Center
9) FL -- Florida Hospital Medical Center Orlando
10) FL -- North Florida Regional
11) FL -- Jackson Memorial Hospital

Declined: Kendall; West Virginia university; east Virginia university (I think this is supposed to be East Carolina-TrashPanda13)
Withdrew: University of South Florida; Orlando Regional Medical Center
Rejected: George Washington
 
Applicant Summary
Board scores: 250s/270s
EM rotation grades: Honors/Honors/Honors
AOA: Yes
Medical school region: Midwest
Anything else that made you more competitive: significant research with multiple publications, ran/sit on board of a non-profit, various leadership positions in COM

Main considerations in creating this ROL
1. couple's matching
2. very much looking for a mixture of county population with university $$ (living the stereotype), lean more towards a 4-year
3. am interested in academics/fellowship (wilderness/EMS)
4. am from the west coast and would like to end up there after residency (grad placement played a lot into the rank list)
5. location
6. breakfast food
7. i want a dog more than most things in the world

1) CO -- Denver Health
Pros: literally skipped away from the hospital after my interview like a schoolgirl, loved the PD, had a great time with the residents. have faculty that share very specific interests. training obviously legendary. PD is very responsive to resident feedback, to the point of changing off service in the middle of the year per resident request. lots of teaching opportunities (both med stud and jr residents), plenty of flexible elective time. think the university and county hospital mix is great. i'm not going to residency to slide through something easy, so wasn't super bothered by the "work hard" stuff. i thought residents overall seemed really happy and most could justify spending $800 for an epic pass so they must have free time in there somewhere. closer to home, have family/friends in the area.
Cons: none
Breakfast: bagel deli is delicious

2) OH -- University of Cincinnati College of Medicine
Pros: home program, i love everyone here, the faculty and residents are all super wonderful. leadership is very responsive to resident feedback. training again obviously legendary. opportunity to become a flight physician is unique and i think adds a lot to the training. i think they have the best curriculum and allow for tons of career exploration with early elective time. patient population is very much a mix of a county and university population (it's the university hospital but also the only safety net in the city). the city is actually pretty neat and close proximity to red river gorge provides plenty of backpacking and climbing opportunities. honestly choosing between here and denver was really hard and my SO and I talked about it for hours. could easily switch these two and wouldn't bat an eye.
Con: further from home, but actually none
Breakfast: proud rooster owns my heart

3) CA -- University of California San Francisco/ Fresno
Pros: very close to home, WILDERNESS MED (park med program is dope), residents here have the most procedures in the nation (someone graduated with five real person crics last year). has a midwest-y vibe in that it's the only level-1 for hundreds of miles so everything comes through there. residents are super laid back and had a great time at the dinner. SO rotated here and loved it and we are looking for essentially the same stuff in a program so i trusted him.
Cons: not as many leadership/teaching opportunities as at Denver or Cinci (ie running the ED, etc)
Breakfast: i personally did not eat breakfast here, but SO had a cinnamon roll pancake, and the Ahwahnee is only like 1.5 hours away (brunch there is amazing)

4) IL -- University of Chicago Medicine
Pros: i think this is chicago's shining star. i loved the residents and the PD. again, program leadership is incredibly responsive to the residents' needs. one of the apds begins meeting with every resident partway through first year to start outlining longterm career plans to ensure that each resident gets exactly what they want out of residency (this was best demonstrated to me by the fact that every year for the past several years they have placed a resident into a wilderness med fellowship even though there is 0 wilderness in chicago and U of C has no wilderness faculty). dinner was super fun. new trauma center is crazy busy, being in the heart of south side you get plenty of county feel with buckets of university money.
Cons: chicago is neat but parks and a lakefront don't count as outdoorsy **** for me and it is hard to get out of that city without flying out of the mess that is O'Hare
Breakfast: Valois

5) MN -- Hennepin County Medical Center
Pros: i interviewed with Reardon, that's literally all that needs to be said. honestly though, the strength of ultrasound and airway training here is probably unparalleled. faculty is very do-it-yourself minded and wants the residents to own everything that comes through. the hyperbarics stuff is pretty cool, really good addiction medicine and tox. dinner was super fun and the residents were awesome. training obviously legendary, very county population. loved minneapolis even though it was 10 F outside in november, city is super art-oriented.
Cons: it was 10 F in november. no wilderness med, ems is meh
Breakfast: Nicollet diner was absolutely delicious

6) NC -- Carolinas Medical Center
Pros: most fun residents on the trail. loved the faculty on interview day. leadership is very responsive to resident feedback and has made multiple changes to the program in the past few years. the hospital has buckets of money and you can do pretty much anything you want., but again serves as the safety net hospital. ems here is super strong. i liked charlotte well enough and it's pretty close to the smokies which are good for living my best em stereotype life
Cons: nothing really a con, just didn't give me the FEELZ
Breakfast: Amelie's French Bakery DAMN yes

7) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: Sarah Williams is my dream woman. She is amazing and inspirational. the residents here are a little on the nerdier side for sure. TONS of money available. have a county site but spend negligible time there. Paul Auerbach is here and thus wilderness medicine opportunities are amazing. the upcoming year will be their first class of fourth year residents so i'm sure there will be some hiccups along the way but they seem very open to feedback and ready to change things as needed. close to home/family/friends
Cons: i wish they spent more time at the county hospital, honestly that's the main problem i have. probably would have moved up a slot or two if it was closer to 25-30% rather than 11%. also that damn bus tour during the interview was exhausting
Breakfast: didn't eat breakfast while i was there, but the real answer is to drive to santa cruz for cafe brasil

8) ME -- Maine Medical Center
Pros: what a wonderful place. the most down to earth residents and faculty i met by a lot. only game in town and for basically the whole state and some of vermont. wilderness med is built in to the curriculum, ems is good. faculty is really invested. PD is an odd duck but i really liked him. patient population is pretty white and pretty old so there is a chunk of pathology that might be missing. otherwise the training seems really solid, residents felt really confident. portland is a cool little town and the food is insane. white mountains are close too
Cons: job placement seemed pretty good overall, but most people stay in the area, which is not where i want to be long term at all. the town is pretty small and the closest real city is boston which i don't really like.
Breakfast: the holy donut!

9) IN -- Indiana University School of Medicine
Pros: overall just had good vibes from the program. the residents were really awesome and i had a good interview day. i like the mixture of sites and eskenazi has a jail wing which i really like (i think this patient population is really great to work with). very solid program, good job placement. didn't get to spend any time in indy, so not sure about the city, but stayed with COM alumni and they were telling me about the restaurant scene, etc. surprisingly good hiking opportunities in indiana too.
Cons: seems that there were some limits on autonomy in the ED as far as leading resuscitations, etc. SO not super sold on the program. neither of us really excited about living in indy
Breakfast: travel complications prevented me from eating breakfast in the city

10) CA -- Los Angeles County/University of Southern California Medical Center
Pros: unparallelled. autonomy. seriously. rotated here. someone on the spread sheet said the residents could be attending after pgy2 year and i tend to agree with that. they run the jail ED starting halfway through pgy2 year. ED volume is insane. the residents are super badass and i got along great with all the residents i worked with. faculty also in general was super wonderful, excited to teach, and very good at giving specific constructive feedback. new PD is genuinely one of the kindest humans i've ever met in my life. 12s are what they are, everyone has an opinion, i don't really care one way or the other. LA is what it is, everyone has their opinions on it. traffic sucks, proximity to mountains, beach and desert is pretty dope
Cons: very little elective time, not a lot of academic focus. there are definitely opportunities, but not much time to go for them. also these residents were tired. no international opportunities
Breakfast: Dinah's

11) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pros: disclaimer - this would be in my top 3-4 if my SO liked the LA programs. loved the residents, huge plus that they had in-n-out at a brewery for the dinner. really liked the residents, had a great interview day. has more of an academic focus than LAC, and with a lighter shift load (9s) and more elective time, seems to have more time to do things outside of clinical work. tons of on-shift teaching, really liked the way their shifts are set up. thoughts on LA above
Cons: not a lot of elective time. no international opportunities
Breakfast: Dinah's

12) MI -- University of Michigan
Pros: again, really liked the residents and faculty, they were super friendly. this program is modeled after cinci curriculum-wise and i think they have made some really good modifications while keeping the same basic outline. the opportunity to work up at flint is pretty sweet and i think the three-hospital model does a really good job of capturing a huge pathology base. a lot of good wilderness opportunities, sweet flight ems opportunities. ann arbor is small and white and walkable which is 1/3 things that are good. those people LOVE to recycle and compost though so i can definitely get down with that.
Cons: LOTS of driving to various sites. ann arbor is what it is. i don't give a flying **** about college sports.
Breakfast: didn't spend enough time here 🙁

13) RI -- Brown University
Let the jokes roll
Pros: super fun dinner with the residents in an adorable house with several dogs. on interview day i talked to a faculty member for a long time about pickling home grown vegetables and a pig roast that they did for the residency last year (these are things that are very important to me). only level 1 for miles, huge variety of pathology, safety net hospital with BUCKETS of money. good autonomy. curriculum again modeled after Cincinnati and i think they've modified it well to fit their mission. providence is cool enough, lots of good food (lots), outdoorsy stuff is apparently somewhere but i would have to be convinced of such
Cons: just wasn't excited enough about the program to live in providence. i don't think there's anything that's a true con, just didn't give me the FEELZ
Breakfast: didn't have time for breakfast, but had a delicious dinner after the interview

14) WA -- University of Washington Emergency Medicine Residency Program
Pros: Harborview is dope talk about a county hospital. also the flight experience is super great. residents were cool. i LOVE seattle it's my favorite city ever
Cons: did NOT like the PD. she complained a lot about couples in the program, she reacted poorly when asked about what changes were upcoming in the program (this program is 7 years old, it is far from perfect). residents talked about turf wars with anesthesia and surgery.
Breakfast: shameless plug for my friend who owns Salmonberry Goods bakery

15) IL -- John H. Stroger, Jr. Hospital of Cook County
Pros: loved the residents. unsure about the lack of PD at the time of interview. obviously pedigreed, but was not convinced that they are continuing to earn the reputation. patient population definitely what i'm looking for. really strong addiction medicine done in the ED.
Cons: little elective time, no wilderness, weak ems

Breakfast: BroBagel

16) IL -- McGaw Medical Center of Northwestern University
Pros: loved the focus on creating leaders. residents and faculty were cool. i thought the PD was sort of sweet and earnest. i appreciate the amount of ICU time, though wish they traded one month for elective time. obviously tons of money and opportunity to do basically anything. supplement main site with rotations at gary and lakeview for county and bread-and-butter community experience.
Cons: not very much elective time considering the academic nature of the program. had a little too much attitude for me. think the purple jacket on match day thing is super weird.

Breakfast: Valois and BroBagel were my Chicago breakfasts of choice. also wormhole coffee

17) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
Pros: liked the residents, definitely on the nerdier side. liked that the chairs both at the brigham and MGH seemed super invested and involved in the program (they interview every single interviewee). obviously tons of money. good wilderness stuff.
Cons: some question of autonomy, seems that there is a lot of consulting. i really don't like boston.

Breakfast: the Friendly Toast

18) MA -- Harvard Affiliated Emergency Medicine Residency at Beth Israel Deaconess
Pros: 3+1 format is super cool. residents all seemed super happy
Cons: too many sites

Breakfast: The Friendly Toast

19) MA -- University of Massachusetts
Pros: only level 1 for a while, residents and faculty were all nice, PD is super dedicated to the residents (one resident had to leave for personal reasons for 2 weeks and the PD worked all of their shifts).
Cons: no FEELZ, nothing really wrong with it

Breakfast: didn't eat breakfast here

20) IL -- Advocate Christ Medical Center
Pros: strong name in chicago. great autonomy. faculty seemed pretty cool.
Cons: no real chance to get to know the residents, not quite academic or county enough for me

Breakfast: see previous chicago stuff

21) Henry Ford
i was just bored all day. the program i'm sure is really great and it obviously makes strong physicians, but i didn't click with any of it

Anything else to add? Sorry for the brevity at the end, this list was ****ing exhausting to make

Interviewed at but did not rank: NY Presbyterian Queens, U New Mexico, Rush

**UNM I think is really great, there were SO many dogs, but they don't have super great academic placement from what i could tell (~10% into fellowships over the last 20 years, and the graduating class this year 7/12 are staying at the albuquerque community hospital) which is why it fell off the list. new mexico is my dreamland so i was sad.

Declined: UCLA-Olive View, NYU Bellevue, SUNY Downstate, UTSW, Johns Hopkins, UC Sand Diego, Christiana, Detroit Sinai Grace, Detroit St. John, Thomas Jefferson, Georgetown, George Washington, Cooper, Temple, UT Houston, Ohio State, St. Lukes, UH Cleveland, Metro Health, UPMC, UC Irvine
Declined waitlist: OHSU, Highland, SFGH
Ghosted by: Maricopa, U of Arizona, Jacobi, Louisville, Detroit Receiving, Wake Forrest, Duke, UC Davis, Mt. Sinai
Rejected: U of Maryland, Emory, U of Utah, Texas Tech, UNC, BMC
 
Applicant summary
Board scores: 240s/260s
EM rotation grades: Pass (P/F only)/High Pass
AOA: Yes
Medical school region: Southeast
Anything that made you more competitive: multidisciplinary research/pubs (not in EM),

Main considerations in creating this ROL: niche career plans academics/opportunities, location

1) NC -- Carolinas Medical Center
Pros: rotated here/loved the people and the teaching. supportive environment. one facility. close to home/family. low COL. really like Charlotte. great benefits.
Cons: academic opportunities less available than #2, alumni base tends to stay close to home

2) TN -- Vanderbilt University
Tough no. 2.
Pros: huge alumni base. love the education style/focus. numerous academic opportunities/resources. great benefits.
Cons: farther from home/family. Nashville was too touristy for me/ higher COL.

3) FL -- Orlando Regional Medical Center
Pros: good mix of academics/community. residents seemed genuinely happy. good name/rep in the region.
Cons: 12 hour shifts as an intern.

4) FL -- University of Florida - Jacksonville
Pros: general badassery, really got along with faculty.
Cons: not very academic, intern year seemed pretty rough schedule-wise.

5) SC -- Medical University of South Carolina (MUSC)
Pros: great location, chill faculty/residents.
Cons: not a huge rep in academia, smaller/newer program

6) CO -- Denver Health
Pros: obviously people get trained well. the prestige is there for a reason. Denver was cool. great didactics.
Cons: 4 years without a great explanation imo for the fourth year. they work an unreasonable amount.

7) FL -- University of South Florida
Pros: location. cool residents/faculty. rotations tailored to EM. have family nearby.
Cons: not great peds exposure or academics. most people stay in town

8) VA -- Virginia Commonwealth University (VCU)
Pros: close to family. good academics/ have tons of money for research, new ER/new trauma bays, new peds hospital coming.
Cons: I really just didn't get along with the residents. faculty was hit or miss- Dr. Moll was great though.

9) NC -- Duke University Medical Center
Pros: close to family, research opportunities.
Cons: rubs me the wrong way that it's still under surgery. consult heavy. the pre-interview dinner was a journal club.

10) VA -- Carilion Clinic - Virginia Tech Carilion Emergency Medicine Residency
Pros: great faculty/residents. research opportunities in my specific area.
Cons: really hate the location. too small, not enough diversity in pathology.

11) NC -- Wake Forest University
Cons: Winston-Salem was super depressing, as was the 70s/80s decor in the interview building.

12) TX -- CHRISTUS Health / Texas A&M


Declined: Medical College of Georgia, UT Southwestern, UT Austin, UT Houston, George Washington, Georgetown, University of Pittsburgh Medical Center, FSU Sarasota, University of North Carolina
Rejected: Emory
 
Applicant Summary
Board scores: 230s/260s
EM rotation grades: Honors/Honors/Honors
AOA: Yes
Medical school region: Northeast
Anything that made you more competitive: 3 Top 10% SLOEs (mentioned during interviews), honors for all 3rd year rotations, one of my SLOEs repeatedly got brought up because of how positive it was, pretty sure that was what really got me my interviews

Main considerations in creating this ROL: Clinical training, job placement around the country, bigger and well-placed alumni network, location, gut feel. I realized I don't like a pure-county program but like hybrids or academic places with rotation at underserved areas more. 4 vs. 3 ended up being arbitrary to me (3 with obvious financial benefit, but I just liked many of the 4 year programs too much)

1) CO -- Denver Health
Pros: I would take the PGY2s here over many of the PGY3s and 4s around the country, even some of the attendings. The "pull-back" shifts really push you to learn to be a real EM doc, not seeing individual patients but seeing the department. Residency is ultimately about clinical training for me, and I thought I'd get the best training here. You can go anywhere and do anything after leaving here. Location is a huge plus, I went skiing for 2 days before the interview, that definitely helped. Denver is sunny, COL is rising but nothing compared to coastal cities, can still have a house with a yard if I want. SO loved the city too, so this ended up becoming a consensus #1. All 8s. Huge alumni network. Residents big outdoorsy types and ski/climb/hike on days off. Denver with an underrated food scene and amazing breweries.

Cons: Although I'm confident that the malignant rumors are not true (I've spoken to the residents and grads from there), there's some level of uncertainty going into it. The working hard thing doesn't bother me much, and 21-22 8s in 28 days is really not bad. The only thing that's different here than others is that there's no shift reduction. 1 or 2 shifts a month isn't going to make or break my wellness.

2) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
Pros: The residents here felt very accomplished, many of them with previous careers, multiple degrees, many publications, felt like they were really going to be driving the field in the future. Even with that accomplishment they didn’t feel pretentious or arrogant to me as some of the others have mentioned. I think this place gets a bad name because Harvard/MGH/Brigham doesn’t mesh with the personality of EM. But the faculty and residents here are still EM people, they’re just also very polished professionally. I did a shadow shift at the MGH acute side and was very impressed with the PGY3 placing chest tubes, central lines, with multiple undifferentiated sick patients coming in. Clinical training here is not poor like others have suggested. Big alumni network around the country, and the Harvard name is hard to ignore and can help if you want to do anything as an exit strategy post-EM.

Cons: Boston COL is high so I couldn’t get a house or a bigger apartment. Not a ton of outdoorsy options around Boston, although Vermont, New Hampshire, and Maine are not too far away for skiing/hiking.

3) MA -- Harvard Affiliated Emergency Medicine Residency at Beth Israel Deaconess
Pros: Everyone loves the 3+1, how could you not love that flexibility. The chair came from Denver, created the HAEMR program at MGH, and then the program at BI, so there’s a lot of thoughtfulness in the curriculum. Many training sites which is a negative for others but I think it would allow me to learn to adapt to different hospitals, EMRs, and staff. I had a great time with the residents here on the pre-interview social. Sushi during every journal club is pretty amazing (and SOs are invited every time!) Had a hard time with BI and MGH, ended up putting MGH because many of the BI residents stay in the New England area (by choice), I wanted to go to a place with a bigger alumni network around the country.

Cons: Same as the other HAEMR program

4) IL -- McGaw Medical Center of Northwestern University
Pros: I had the most “feels” at this program. The chair’s talk was great, the only one that actually gave that 30,000 foot view and made me think of my career in the long run. We had the pre-interview social at the chair’s house, and the faculty was there too and it felt very relaxed, homey, family-like environment. This program felt like they were doing everything they can to create leaders in the field (for example with their integrated MBA program or the physician scientist training program). The clinical training here is underrated as well, they do the same number of Cook trauma months as Cook residents, and Gary will get you great community training that more than makes up for the “purple palace” feel at the main site.

Cons: The only thing that held this place back for me was that I didn’t want to be in Chicago as much as Denver or Boston. Super cold winters without mountains, what’s the use!?!? If this place were on either coast or in Utah/Denver, it would be my #1. I thought they did too much post-interview communication. Appreciated the love but it was a bit much.

5) RI -- Brown University
Pros: Brown felt similar to Northwestern in many ways, with the program tailoring their experience to the residents goals and needs. They have the resources to let the residents do what they want, but also a huge catchment area that gives the residents a great clinical experience. Entire Rhode Island, parts of southern Massachusetts and eastern Connecticut are all theirs. I stayed with an intern for the interview and she had nothing but great things to say about the program, and she was on the TICU rotation, so their wellness is good too. Providence is an underrated place, very close to Boston if you want sports/music/other city amenities, but low COL.

Cons: SO would have a hard time finding a job here. Liked the PD and would love to work with her, but her energy was a bit in-your-face and can’t tell if that would get too much in 4 years.

6) IL -- University of Chicago Medicine
Pros: 3rd oldest program in the country with a huge alumni network around the country. You can get a great clinical training at an institution with a good reputation in and out of medicine and EM all within 3 years with a brand new level 1 trauma center and the resources of U Chicago. PD was very personable, and I could see myself going to her with career advice and just life advice in general. Their international flight program is an awesome way to travel while getting paid.

Cons: Just didn’t vibe with the residents as much. They felt oddly immature to me on interview day and some moments that lacked professionalism.

7) MA -- Boston Medical Center
Pros: The history of this program is really cool, with an old school mission driven county hospital that later merged with a University hospital, now all under one roof. Probably the most mission driven program that I interviewed at. Great pathology with both medically sick patients and lots of trauma. One of the oldest programs on the East coast with a big alumni network.

Cons: Boston COL is high. Didn’t want to train at a program that was 1-site heavy. Just didn’t vibe that well with the residents either. They didn’t sell their 4th year well, felt like it’s 4 years for the sake of being 4 years.

8) PA -- Temple University School of Medicine
Pros: Went into the interview season thinking this would be my #1. 3 years, love Philly (low COL and livable city with all the amenities I could want), crazy high penetrating trauma in North Philly, very sick undifferentiated patients. It’s one of the underrated programs nationally, in my opinion. The PD was very personable and had the “guy I wanna grab a beer with” feel. Mission driven program, and the faculty and residents seemed very close.

Cons: In the end I realized I wanted somewhere with more resources and also a better patient diversity. My home program is in an underserved area, and I think I missed out on learning how to interact with and treat an affluent population. I want to be exposed to that variety during residency. Still loved this program though, and think it would give me great training overall.

9) IL -- John H. Stroger, Jr. Hospital of Cook County
Pros: Great clinical training with a huge alumni network, leaders of EM around the country doing amazing things. I’d leave here feeling like I can handle anything. Another mission driven program which I think helps with the burn out during residency. Residents seemed cohesive and buy into the training there.

Cons: The program leadership felt oddly defensive when asked about their medicine floor months. Just didn’t vibe on interview day as much. Another county-only program that doesn't expose me to the university setting or give me those resources. Also in Chicago, which is a fine city but just not for me.

10) PA -- University of Pittsburgh Medical Center
Pros: Another old reputable program with a large alumni network around the country that can get me great training done in 3 years with great job placement. Obviously the jeep is what stands out here, but their other pre-hospital experience is also pretty amazing. Heard some crazy story from residents about the level of autonomy they have in the pre-hospital setting. Variety of clinical settings, with a university hospital, county-style hospital, and community setting too.

Cons: Didn’t vibe well with the PD, the residents had a very mid-west vibe (which is fine but just not what I’m used to or connect with), Pittsburgh is fine but just not where I want to be for a prolonged period of time.

11) NY -- Mount Sinai School of Medicine - New York
Pros: Another program that I had great feels at but ended up dropping for location. They had the most lively pre-interview social here, and for better or for worse the residents really loved hanging out with each other. They stayed way after the set time (I also stuck around for a while because I was enjoying myself so much). Probably the best clinical training with high volume at Mount Sinai and great clinical pathology both medically and with trauma at Elmhurst. You’ll see people from around the world coming in with crazy infectious diseases at Elmhurst, but also see a lot of the bread and butter of EM. Good mix of academic, county, and community experience. Queens has AMAZING food, with pockets of amazing authentic global cuisine.

Cons: Just really don’t want to be in NYC. I want to be able to keep my car and not have to pay crazy high rent. Can’t deal with the public transit system there. Ancillary staff in NY is awful (granted some good ones, but just awful culture of not caring and lack of professionalism). Loved Dr. Shah but he’s leaving/left.

12) NY -- NYU/Bellevue Medical Center
Pros: A huge name in and out of EM and medicine with big alumni network around the country that is backed by great clinical training and a lot of resources. You’ll be working side by side with some of the giants of the field. Another mission driven hospital. With the Brooklyn site, a good mix of academic quaternary center, county-style Bellevue, and a community site in Brooklyn.

Cons: Same as for Mount Sinai

13) CT -- Yale New Haven Medical Center
Pros: Yale name and resources, surprisingly good clinical training with good variety at Yale and Bridgeport. The PD was slightly intimidating at first but then was easy to talk to after a few minutes. New Haven has low COL and I have many friends in NYC that I could easily visit.

Cons: Just didn’t have the feels here, didn’t feel like they had a good reason for the 4th year, and a lot of the residents end up working in the community at jobs that I could get from a 3 year residency. New Haven is fine but isn’t exciting to me.

14) PA -- Hospital of University of Pennsylvania
Pros: Another big name inside and outside of medicine with a lot of resources. PD was personable. Best resident lounge by far. Played super smash with residents while waiting for the interview, the interviewer came in and watched me play and cheered me on. Love Philly as stated before. Their trauma bay sees a lot of penetrating trauma from West Philly in the summer time.

Cons: When I asked the residents why they wanted to be there, a lot of them answered in a way that suggested it wasn’t their top choice. Their grads are getting a lot of CMG jobs on the East Coast that I could get from a 3 year residency. 4 years didn’t seem worth it for me here.

15) DC -- Georgetown University Hospital/Washington Hospital Center
Pros: I’ve lived in DC and think it’s a great place to live, other than the lack of mountains nearby. Had good feel from the residents and faculty, and thought Dr. Bhat was very personable. 3 years.

Cons: Most of the residents said “location” why I asked why they chose the program, which isn’t the biggest vote of confidence for the program. A little too fratty vibe from the residents.

16) NY -- Mount Sinai St. Luke's Roosevelt Hospital Center
Pros: Rotated here and thought they had the happiest residents here. The weekly conferences were great, mainly run by the two APDs who are really up and coming leaders of the field. The leadership are all young, relatable, and great teachers that bring up relevant topics in an easy to digest way. On shift teaching was great. They have 45 minute breaks for every shift which does a ton for wellness. St. Luke’s ancillary staff was the best of any NY hospital I’ve worked at.

Cons: When I finished the rotation I liked it so much I was nervous I wouldn’t like other programs more. Ended up realizing I really don’t want to be in NY and want to go to a program that sets me up better for academics. Thought their 3rd years looked uncomfortable running traumas and codes.

17) DC -- George Washington University
Pros: DC is a cool place to live. They had a good focus on medical education. Health policy seems to be strong here if that's your thing.

Cons: 4 years just didn't seem worth it for me here. Residents looked tired to me and not very excited about the program.

18) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
Pros: Old school county program, one of the few that have real trauma in NYC. Big alumni network.

Cons: Montefiore/Jacobi is crazy in a bad kind of way, at least for me. Crazy in a “there are so many patients filling the ED that I can’t even get to my patient without moving 10 other patients” kind of way. A lot of the residents seemed burnt out. In NY, particularly in the Bronx. Very county heavy, even at Montefiore. Don’t get me wrong, this will get you great clinical training with great job placement around the country, it just isn’t the right program for me.

19) NY -- New York Presbyterian Hospital
Pros: I rotated here, and their weekly conference was pretty good, especially the theme days they had. Some of the attendings I worked with were really good teachers and knew their stuff.

Cons: This program confuses me in that it’s a huge name in and out of medicine with access to tons of resources. Clinical pathology at the Columbia campus should be good. Just felt like a lot of aspects about the program (teaching, clinical exposure, job placement) were sub-par compared to what I would expect from an institution like this. I asked a resident why he chose to come here, and his response was “there’s not much to say other than the location” which is a huge red flag for me.



Anything else to add? I had a hard time cutting down on interviews as I was lucky in being able to schedule a bunch of interviews at every city in one trip. Interview trail was awesome, got to learn a lot about the field, traveled, had free food and beer, and met people doing amazing things with their career. It made me realize I made the right choice going into EM. I don't think my app was anything special except for my SLOEs, and I think all of our experiences show how SLOEs really make or break your app. Grateful to have had the chance to interview at these amazing programs, and hope to work with some of you during residency and potentially beyond!

Applied to: All of the above plus the ones below
Declined: Stony Brook, Christiana, Maimonides, King's County/Downstate, Maine Medical Center, John's Hopkins, Hofstra/LIJ
Interviewed at: All listed above
Withdrew prior to hearing back from: None
Rejected: Ghosted from Maryland, Thomas Jefferson, and Drexel
 
Applicant Summary
Board scores: 200s/250s
EM rotation grades: Honors/High Pass/High Pass
AOA: No
Medical school region: Southeast
Anything that made you more competitive: Military medicine background. EMS experience/leadership. Some research.

Main considerations in creating this ROL: Location. Spouse's job/transfer prospects (current resident in another specialty). Gut feel. Perceived happiness of residents. 3 yrs >> 4.

1) TX -- UT Southwestern Medical Center - Dallas
Pros: Fun pre-interview social, margaritas were great. Residents were incredibly positive about their experience. Beautiful new hospital. Solid reputation overall with great pathology. Good interactions with PD and faculty. Tons of resources and fellowship opportunities. Dallas seems like a cool city with fairly low COL. 2 months in New Zealand is literally my dream. Spouse wants to transfer here. I had high hopes going in, and left more impressed than I expected.
Cons: Prefer a smaller class size. Relationship with trauma not great.

2) NE -- University of Nebraska Medical Center
Pros: I was impressed and surprised by this program. Leadership and faculty were really enthusiastic. Residents were all very friendly; I probably stayed out too late hanging with them at the pre-interview social. Loved the hybrid feel (urban, rural, academic, and community experiences). Building the biggest sim center I've ever seen. Felt like I'd get solid training overall.
Cons: Omaha is not the most exciting city. Winter sucks.

3) MO -- Truman Medical Center/University of MO Kansas City
Pros: KC is an underrated city. Great interviews with faculty. Residents were all very friendly, though I was less impressed than some other programs. Solid county population and pathology. Close to spouse.
Cons: Felt like interns were coddled, especially on traumas. Academics did not seem to be a focus.

4) LA -- Louisiana State University - New Orleans
Pros: I love NOLA, despite its many flaws. This program was especially impressive to me. Best new hospital I've seen. Huge ED, cool burn ICU. Residents seemed badass and fun. Tons of trauma and diverse pathology. Great community mission. Also the most fun pre-interview social when they invited us to their holiday party, followed by a bar crawl in the pouring rain. This program would compete for #1 if not for 4 yrs and spouse's residency situation.
Cons: Just not sold on the 4th year; it seems redundant. Hurricanes blow.

5) CA -- University of California Irvine Medical Center
Pros: Great location. I was almost sold just based on the location of the social in Long Beach overlooking the water. PD obviously passionate about training residents. Small program so faculty and residents know each other very well. Solid US experience. Essentially a county hospital for OC. Great job placement in SoCal.
Cons: High COL. Not crazy about possibly commuting in traffic from Long Beach every day. Program seemed to emphasize speed/moving the meat, though that may have been my misperception.

6) CA -- Loma Linda University School of Medicine
Pros: Friendly people, both residents and faculty. Odd interaction with PD, but the other attendings I interviewed with were very impressive. Multiple international elective opportunities. Driving distance to mountains, desert, and beach.
Cons: Religious aspect a little off-putting. No meat in cafeteria. Inland Empire is not the best locale, but Redlands seemed like a decent place to live.

7) IL -- Rush University Medical Center
Pros: New-ish program with enthusiastic leadership. Chicago is awesome in summer, less so in winter. Rotate at Cook Co for trauma. Seemed like the program was going smoothly for being so new. Diverse residents.
Cons: Growing pains with new program. Most traumas diverted to Stroger/Cook.

8) IA -- University of Iowa Hospital & Clinics
Pros: Well-established program. Mostly cool faculty. Friendly residents. Like the Sports med fellowship option. Great research opportunities. Liked all the event medicine with the university right there.
Cons: ...it's in Iowa. Parking situation is terrible. When I asked residents what they do for fun, basically the only answer I got was that they drink.

9) GA -- WellStar Kennestone
Pros: All the interns sold this program very well. Incredibly busy hospital (ED volume like 150k+). Interns already basically done with all procedures 7 months into residency. Solid faculty for a new program. If this program weren't so new, I would have ranked it higher. As a Braves fan, living next to their stadium would be dope.
Cons: Growing pains of young program. Program still trying to figure out where to do OB training for residents.

10) FL -- Aventura Hospital & Medical Center
Pros: Sunny south Florida. Nice hospital. Diverse patient population, though a ton of geriatrics. Feel like the training would end up being just fine overall.
Cons: Worst interview day. Disorganized from start to finish. PD couldn't find my application, then rambled for 20 minutes and never asked me a single question.

Anything else to add? I had a family tragedy the day before my Step 1, and my score ending up being terrible. I worked hard to improve for Step 2. Just putting this out there that people can absolutely bounce back from a tough Step 1 if you put your mind to it. Just crush Step 2, get solid SLOEs, and apply broadly.

Applied to: 49 total
Declined: HealthPartners/Regions (spouse vetoed Minnesota), Loyola, UI - Peoria
Rejected: UIC, Presence Resurrection, Georgetown, Mayo, UC Davis, Wash U - St Louis, UCLA Harbor, UCLA Olive View, LAC/USC, U of Chicago, Denver, Utah, Stanford, Kaiser SD, Hennepin. Ghosted by several others. Waitlisted at Emory and Northwestern.

Note from @TrashPanda13: Job well done in spite of the poor Step 1 score. Looking at where you interviewed, I thought it was a typo at first. Sorry to hear about your family tragedy.
 
Applicant Summary
Board scores: 250s/260s
EM rotation grades: High Pass/High Pass
AOA: Yes
Medical school region: Midwest

Main considerations in creating this ROL: Pretty much an open book geographically, so I was looking for badass training in a large city. 4 >> 3 years. 8h > 12h shifts. Warm weather >> Cold

1) CO -- Denver Health
Overall: So nervous interviewing here with all the negativity that surrounds the Denver name. I was sincerely blown away by the residents, both by their competence in the ED but also how much I liked them and just enjoyed hanging out with them (unlike most pre-interview dinners, this one was truly enjoyable). I can honestly say I'm surprised it ended up here at #1, but I have no concerns and feel very confident in my decision.

Pros: Not much here that hasn't been said. Denver knows what they are doing and they do it well. You'll be a badass coming out of here and probably get any job or fellowship you ever wanted. One major pro for me was the 2 sites between the county site Denver Health and the academic site at UC. It was important for me to find a place where I got exposure to both. Also I'm a Denver fan (mountain life >> beach life).

Cons: Work hours (no surprise here). After asking every resident I could and physically looking at many of their schedules, I saw that they seemed to work 20-21 shifts a month on average. I never saw the dreaded 24/28 rumor, but I'm sure it is possible. The worst part for me is the "circadian scheduling" where you change shift times every 2 days (2 swing, 2 night, 2 day). Realistically, I made peace with this. Residency will be hard, but this is the only time I'm going to get to be a doctor with training wheels, and I want to see everything I can and be as prepared as possible to train anywhere when I graduate. If that means working a little bit more to see so many more patients, I'll take that on now gladly.

2) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Overall: This program wasn't on my initial radar list but was a happy surprise and one of only two places that truly gave me the warm fuzzies.

Pros: 50/50 County/Academic Split was what drew me out there and I think that it would train me well for multiple environments. UCLA is also a pro in and of itself. They have RESOURCES. It's like the opposite of county in that sense (in the best way). "No tox rotation here? We can just send you to New Zealand for a month". They have funding for you to do anything and connections and hands in anything you could possibly be interested in. I wasn't initially crazy about the idea of LA, but I had a good visit there and enjoyed Santa Monica pier and the area in general. Lastly the people here were incredible. I really liked the PD and Chair (who invited us to his house for interview dinner), but really felt like the residents were chill and fun people.

Cons: The main con here that I heard about before is the commute. The commute to OV can take an hour or so, although the residents downplayed this by saying that they are optimizing when shift ends so you don't hit rush hour. Another major negative here is the dreaded 12 hour shift. They claimed that they are now starting to have more 8 hour shifts added in. Lastly I've heard rumors that OV is not the county "gun and knife club" that you would see at LAC/Harbor/Highland.

3) CA -- Alameda Health System - Highland Hospital
Overall: Thought this would top the list, but just wasn't as impressed as I wanted to be. This probably came down to more of a negative "gut feeling" then anything else.

Pros: It's Highland... so there is definitely the reputation factor here. These residents seemed very intelligent and happy. QOL is awesome here with 8 hour shifts that decrease in amount through 4 years.

Cons: A little bit of an elitist vibe here. Not so much that I disliked it, but it didn't exactly give me warm fuzzies. They are super super county and I feel that is to the detriment of learning management of complex medical management. The attendings are pretty in-bred and the faculty pool is so small I worry about learning a variety of practice patterns. Some of the attendings I met on interview day were just kind of weird and off-putting. Not an Oakland fan and I want nothing to do with SF and the prices that go with it.

4) IL -- John H. Stroger, Jr. Hospital of Cook County
Overall: If this program were in a warmer large city... I would be hard pressed not putting it at #1.

Pros: The pathology, volume, and acuity of cook county are pretty legendary and I felt their residents were incredibly prepared. I also loved the mission. I realize that can be a really lame thing to say, and I wouldn't have expected myself to be moved by "the mission". But Cook really seems to care about their Chicago neighborhood, and they exemplified "county" in the best sense of the word.

Cons: Chicago... I just don't want to be cold and seasonal affective disorder is real. They were another program like Denver that worked very hard unapologetically. Sadly I can't remember the exact hours/month but it was a consideration.

5) OH -- University of Cincinnati College of Medicine
Overall: For me to put a program in Cincinnati OH (cold, smaller city, midwest) in my top 5, they had to be astounding, and they were.

Pros: The most established/oldest program in the country. They give off the vibe that they know exactly what they are doing and continue to have great results. Additionally they were definitely the swaggiest interview day (paid hotel room, gift bundle at the hotel, best coffee mug ever). They have a lot of money and they aren't afraid to show it. I think they take really good care of their residents here. Additionally the opportunities after residency seems endless having sent grads everywhere regularly. Any type of interest here was well covered, but they seemed particularly strong in EMS/Flight.

Cons: Cincinnati OH... yikes. This program is so good though and the city is not *that* bad. So I could do 4 years here for the sake of being part of this legendary crew. The residents were a little weird and one was particularly abrasive.

6) IL -- McGaw Medical Center of Northwestern University
Overall: To be honest, this one moved the most up and down and back up again throughout the season. At the end of the day, I had to ignore everyone else's thoughts and go with my gut.

Pros: Interview day was great for me. While I could recognize the elitist vibe, I really respected their goals and didn't get a bad feeling from anyone I spoke to. The residents were very happy and friendly and I really clicked with a couple of my interviewers. Northwestern has a lot of resources to help with extracurricular activities and interests.

Cons: Trauma is a big question mark here. Multiple interviewers admitted that their main site Memorial doesn't see much trauma, so they ship to Cook County or Gary to get their trauma rotations in. Additionally they spend a ton of time in the ICU which isn't really my cup of tea. Lastly, I met many people on the trail who hated this program, called it elitist, and worse. I guess I didn't see it, or what I did see of the "elitist" title I didn't think was malignant.

7) RI -- Brown University
Overall: Another surprise in the race, and another school that is 100% hurt by its location. However the take away for Brown: These were the happiest residents I met on the trail, bar none.

Pros: Strong clinical training in a hospital with a large catchment area and no competing EM residencies nearby (all of RI, some Connecticut, some Massachusetts). Low COL in Providence, great QOL with 8 hour shifts. Every single interviewer was very personable and made me want to go there. The incoming Chair interviewed everyone as well.

Cons: Providence RI (its tiny AND cold). Not much prestige in the EM world although I think this is changing. I sometimes found myself questioning if having this great QOL somehow compromises clinical training (I realize that is crazy... I'm concerned because they seemed too happy and chill).

8) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
Overall: Hahhhhvahd. Within the EM world, Ivory Towers have generated a knee-jerk reaction of negativity and inferiority to their county counterparts. While I have some other Ivory Towers listed above... this would be the mother of them all. I fall on the side of believing that while the Ivory towers certainly lagged in the EM game back in the 90s, the landscape is changing and programs with money are quickly becoming very competitive and able to support their students.

Pros: At the end of the day, I feel like the name "Harvard" just can't hurt me. There are really smart people here and I think I would receive an excellent education with support in any additional fields I would hope to be involved in. They also become experts at managing complex care patients.

Cons: This is a 2 site program where both are massive academic tertiary care centers (Mass Gen and Brigham). To me, this is a major downside and pretty much undoes the benefit of having multiple sites. They tried to sell that MGH was like a county population. But I don't really buy it. Additionally I met some very salty residents who weren't happy to be there. Lastly, Boston doesn't seem like a very fun city, and it's cold.

9) CA -- Los Angeles County - Harbor-UCLA Medical Center
Overall: Biggest disappointment

Pros: Harbor is the countiest of county programs. They see underserved LA population and clinically they have great training. I'm sure I would come out of here as a competent, impressive county doc.

Cons: Harbor is the countiest of county programs. They work with limited resources both in the ED and in their support of their residents (no funding for any sort of aways or international travel). Additionally, there was just no umph factor here. I expected to be wow-ed by Harbor but honestly it was just sort of "meh". The residents were chill and fine but no one really struck me as someone I'd want to hang out with. If any of these name-brand programs could be accused of resting on its laurels... I would put that at Harbor's door.

10) WA -- University of Washington Emergency Medicine Residency Program
Overall: Strong program in a cool city... maybe too cool/hip for me.

Pros: Nice split of county (Harborview) and academic (UW) training. Massive catchment area of the entire WWAMI region. EMS is legendary. Overall not blown away but a perfectly good place.

Cons: For better or for worse... it's Seattle. It's pretty rainy, definitely cloudy, and I don't know that I have the requisite number of patagonia fleeces to live here. The residents were also a little quirky. 10 hour shifts here.

11) PA -- Hospital of University of Pennsylvania
Overall: Understated program with a lot of resources and friendly people in a really nice (but cold) city.

Pros: Penn has some awesome facilities (Penn Presby's trauma room was gorgeous). Granted this isn't make or break but honestly it was pretty darn impressive. The people were all very friendly and the residency faculty were from multiple "top tier" institutions. Penn covers west philly and the underserved/sick population that comes with it. Since it is "Penn" they have money and resources and can support residents as needed with extracurricular activities.

Cons: Mostly just rumors but there seem to be a lot of questions regarding the stability of the EM program at Penn. Attendings leaving, bad malpractice coverage. Basically this just made me feel like Penn was a little more unstable of a choice despite the fact that I liked it overall.

12) CA -- University of California San Diego
Overall: San Diego is beautiful. If nothing else I will live here in a heartbeat.

Pros: This program really embraces the multi-site training (maybe too much). They train at multiple sites (5?) and work in county, community, and academic locations. 9 hour shifts (21 max as a PGY1).

Cons: Slightly abrasive PD with Olayami. She is very nice, but just rubbed me the wrong way. They are able to offer help in any extracurricular you could be interested in, but I got the feeling they really aren't great at any of it besides hyperbaric O2. Awkward resident interview, they weren't prepared with anything and there were lots of awkward pauses that just never happened on any other interview.

13) AZ -- Maricopa Medical Center
Overall: 3 years isn't ideal for me but this was my favorite 3 year that I saw. They are clinical badasses in a cool city with lots of outdoor activities.

Pros: Phoenix is really cool. As someone looking for sunshine... this is a winner. 9 hour shifts. Very nice residents who were easy to talk to. They work a month of night shifts so that you don't work nights otherwise.

Cons: 3 years. Not convinced that 3 years wouldn't hinder me from getting fellowships or being hired in academic settings.

14) IN -- Indiana University School of Medicine
Overall: A legendary 3 year program that was impressive but ultimately came off a little stiff and underwhelming.

Pros: Multi-site training between IU and Eskenazi (county). 9 hour shifts. COL is low. Indiana has a great reputation, particularly in the midwest.

Cons: These were the stiffest, most purposely impersonal interviews of the season. While that may have been their intent, it left me feeling like I just didn't connect with these attendings and faculty.

15) MI -- University of Michigan
Overall: A very solid program in a very tiny cold city with residents who ranged from possibly happy to loudly unhappy.

Pros: Michigan alumni network is huge and they've got money to support. Multi-site training at the university, community (St. Joes) and county (Hurley Flint) although only 10%ish is at the county site in Flint. Flight training seems good here and the ED ICU is unique. COL is low in Ann Arbor.

Cons: Besides the cold tiny city... the resident (4th year) who gave my tour gave off a fairly dissatisfied vibe. He openly said Michigan wasn't his #1 (no judgment there) but then went on to say that Michigan is essentially a middle of the road program where you will be "fine". It was just off-putting to hear a resident talk about a program at a school like Michigan in this way.

16) NC -- University of North Carolina
Overall: UNC would train me to be a great doc, but I have no desire to live in Chapel Hill and the 21 12s as a PGY1 was pretty off putting.

Pros: Strong clinical training at multiple sites. If you get to work with tintanelli on shift then you have a solid fun fact for elevator conversations.

Cons: 21, 12 hour shifts as a PGY1 and then things go to 8 or 9 hour shifts (unclear why they are trying to beat their interns into the ground).

17) NC -- Carolinas Medical Center
Overall: Top notch program that just didn't jive with me (clearly NC isn't for me).

Pros: Great clinical reputation. Charlotte NC has low COL and residents seemed happy and had a good QOL.

Cons: 3 years. Single site training center seems like you are losing opportunities to learn how to work in different environments. Most residents go to community from here which creates extra worry for me if interested in fellowship or academia.

18) WI -- University of Wisconsin
Overall: Good, newer program with a really enthusiastic likable PD. If they had a better patient population and had some more years under their belt I would be more tempted by it. Oh and they would need to not be in Madison WI.

Pros: PD is a boss. She is extremely driven, and you can tell she cares deeply about driving this newish program forward. Nice residents overall (although it seemed very college - like and a bit fratty.

Cons: 3 years (granted the +1 is an interesting addition). New program without a strong alumni network. Minimal trauma in Madison WI. When chief resident was asked if they felt ready to practice in any environment there was a very very pregnant pause followed with, "ummmm yeahhhhhh I think so?". So that wasn't the vote of confidence I would hope for in a soon to graduate PGY4.

Declined: University of Pittsburgh, Jefferson, UTSW, Drexel, Duke, Temple, Rush, Henry Ford
Rejected: HAEMR BID, Oregon Health Sciences, University of California San Fransisco, Emory, UT Austin, Vanderbilt


Note from @TrashPanda 13: The following is a comment from the spreadsheet from another individual regarding UNC's shift structure:
"Crazy good list! I just wanna throw something out there for people reading this in the future. You don't work 21, 12s as an intern at UNC (that would suuuck). 12s are only when you are at UNC, so ~60% of the shifts. Also, spoke with the administrative chief about this directly and he said he doesn't know why they say 21. He does all the scheduling and the average is around 19 for an intern and he had never seen more than 20."
 
Applicant summary
Board scores: 210s/230s
EM rotation grades: 3 x Pass (P/F only for all)
AOA: No
Medical school region: Midwest

1) MI -- McLaren Oakland Hospital
2) MI -- William Beaumont Hospital Farmington Hills
3) MI -- Metro Health
4) MI -- Michigan State University/Sparrow Hospital - Lansing

Interviews attended: McLaren Oakland, Beaumont Farmington Hills, Metro Health, Sparrow
 
Applicant Summary
Board scores: 250s/260s
EM rotation grades: Honors/Honors/Honors
AOA: Yes
Medical school: Midwest
Anything that made you more competitive: leadership, strong SLOEs fit,

Main considerations in creating this ROL: SO preferences, location, quality of training, ability to do anything afterwards. I have lots of academic interests, but I think there's a 50/50 shot between ending up in community vs. academics and want the option for both.

1) TN -- Vanderbilt University
A lot has been said about this program that I don't feel the need to repeat. I felt like this was the perfect fit and kind of knew it all along. My SO also loved the idea of Nashville. It just seems like the best move for us right now, and we could see ourselves living in the area long term.

Pros: Educational component is second to none IMO, high volume, intense longitudinal peds experience, strong spousal support, responsive leadership, abundant EMS opportunities, good community AND academic opportunities, optional chief year at junior attending pay, family feel, have full time support staff for research, 3 years, warm fuzzies, strong moonlighting opportunities, married-friendly, Nashville seems to be a great city

Cons: nothing I can think of

2) CO -- Denver Health
Pros: really liked the residents, training is INTENSE but can’t really imagine anything better, would be prepared for anything, would be challenged and constantly pushed to improve, would be able to go anywhere in academics or community, academic site, county site, and community site, Denver is a nice city, weekly M & Ms, liked the new PD, significant others club, tons of EMS event coverage opportunities, scribes starting second year, butterfly ultrasound to take around, highest volume, sees most peds in the country (but probably due to amount of shifts worked), close to family

Cons: Denver is increasingly expensive, wellness could be an issue but I did not get a malignant vibe AT ALL from this program

3) OH -- University of Cincinnati College of Medicine
Pros: solid 4 year program training many leaders, integrated community, both academic and community peds, highest volume peds hospital in country, autonomy with flight, great social and loved the residents, 6.5 months elective, phenomenal EMS and just unique opportunities (Swat, flight, etc), chair is high up in hospital leadership, warm fuzzies, every career opportunity open, pedigree, fourth year really teaches you to teach

Cons: Cincy < Nashville or Denver, nothing much that I can think of, some of the residents/SOs clearly not into Cincinnati in general

4) FL -- Orlando Regional Medical Center
These residents are some of the happiest in the country, and Orlando is beautiful. There is way more to Orlando than Disney. It's not even in Orlando. It drives me a little nuts when I see that listed as a con on other lists. My SO and I would be so ridiculously happy here.

Pros: Orlando, perks, PGY3s run a 75 bed ED, paper charting to start but would then learn epic, solid procedural training, research opportunities, residents are super happy and chill, solid job placements, high volume, fast paced, PEDS experience would be phenomenal. I truly think this program is underrated.

Cons: not many people go into academics, not sure what job opportunities would look like if we didn't want to stay in the south

5) IL -- Advocate Christ Medical Center
Pros: volume, no graduated responsibility, 1:1 with attendings, hit the ground running as an intern, high acuity/trauma, solid integrated peds, outstanding ultrasound faculty, residents able to handle anything, strong mentorship and leadership, not having to drive to a million different sites

Cons: lack of international opportunities, going to be transitioning partly to a new ED while I would be there, commute will be rough regardless of where one lives, we just really aren't fans of Chicago or this would be much higher

6) IL -- University of Chicago Medicine
I thought this was going to be higher before the interviews.

Pros: highest trauma volume in Chicago, high volume with underserved population, no graduated responsibility, international flying experience, good relationship with trauma, very extensive alumni network, Dr. Babcock is phenomenal, 2 3 day weekends per month, Peds is integrated (I believe with dedicated month also), 3 yrs, strong moonlighting opportunities

Cons: not a fan of Chicago, traffic, cost of living is high, they say significant others are welcomed and participate in social activities, but none showed up to the social, the interactions at my interview were just ok, I just didn't feel that I clicked that well. That being said, I'd be thrilled to end up here, and I understand why it is so popular. I think it's just going to keep getting better and better.

7) NC -- Carolinas Medical Center
Pros: Legendary training, solid ICU in second year, Charlotte is affordable, amazing benefits, great academic and community opportunities, nice PD, not many other residencies in system, no competition for procedures, EMS opportunities amazing (with medic-1), loved the residents at the pre-interview dinner

Cons: Just didn’t get great feels at interview, area seemed just ok, weird vacation structure apparently (didn’t hear about this at the interview)

Really what is bringing this down is that my SO and I don't have any connections to the area. I'd be thrilled to end up here.

8) IL -- McGaw Medical Center of Northwestern University
Pros: phenomenal leadership (probably the leader in the country in producing EM leaders), amazing academic and community placements, Gary IN experience, great off-service teaching, connected with Dr. Bailitz

Cons: downtown Chicago, many sites, the rent would be terrible, not the best fit for me

9) IN -- Indiana University School of Medicine
Pros: really is a great hybrid program with two high volume but different sites + longitudinal peds, ICU experiences second to none since 1:1 with attending, low cost of living, awesome spread of academic/community/fellowships

Cons: Indianapolis, prefer smaller class size, SO really not into the idea, just did not get the feels but I know I would have great training here

10) CA -- Los Angeles County/University of Southern California Medical Center
Pros: legendary training, strong history, 4 years with phenomenal job prospects, significant others club, always handling traumas/airway, carry code pager for entire hospital, q6 month wellness retreats, got along well with residents, EMS event coverage, strong ultrasound with one in every resus room, educational component strong, jail ED experience

Cons: basically all 12 hr shifts, LA traffic is horrendous, high COL, not a great parking setup, would just be a huge undertaking to move to LA when we don't plan to settle in CA

I feel weird ranking this low as I really connected with the PD and mission, but SO and I agreed this is not the best move for us right now.

11) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
Pros: Harvard affiliation, liked Brigham chair, getting rid of floor and cardiac stepdown month, literally every single option open after graduation, sick patients, solid mentorship, every research opportunity, liked the residents a lot, family in the area

Cons: Boston COL, so academic that they really aren't into community and I think there is a strong chance I end up in community so I don't think it's the perfect match for me, SO not into the idea

For what it's worth, I did not get a pretentious feel from the program leadership about the Harvard affiliation AT ALL.

Anything else to add? I wish I knew my SLOEs. It would have targeted my application better. That being said, I had no idea I would connect so well with some of these programs (and not with others) prior to my interview. I think people need to go into these interviews with an open mind to find the best fit for you. That being said, I'd be happy at literally any of these programs. COL ended up playing a big factor. I internally freaked out a bit about some aspects of this list thinking I was dumb to rank some programs super low, but go with your gut.

Advice to people with SOs: This is arguably as big of a decision for them, so listen to them. I cancelled interviews at places that were hard nos for my SO. At the end, we made two separate rank lists independent of each other. The top 2 were the same and then there were some minor differences. I listened to their preferences for a lot of the middle of my list, because I had such trouble ordering the programs anyways. I didn't have strong preferences between a few of these, so I found using their preferences helpful. My SO has been a huge help to me in med school, and I think their happiness is as important as mine.

Declined: Harbor-UCLA, UCLA-OV, Hennepin, UMichigan, Emory, Yale, BIDMC, UF-Jax, WashU, Cook, Mayo, UNC, Duke, OSU, Metrohealth, UH-Case Western, Iowa, Rush, Resurrection, some others
Interviews attended: All ranked
Rejected: Louisville, Rush
 
TrashPanda13 said:
1) CO -- Denver Health
Pros: I would take the PGY2s here over many of the PGY3s and 4s around the country, even some of the attendings.
Click to expand...

I've been on SDN for a decade. This is in contention for one of the most ridiculous things I have ever seen posted.

Edit: I see I'm late and others have already commented on this whopper.
 
jw3600 said:
I've been on SDN for a decade. This is in contention for one of the most ridiculous things I have ever seen posted.

Edit: I see I'm late and others have already commented on this whopper.
Click to expand...
Clearly someone who has no idea what they’re talking about. In my experience all graduates look about the same, within normal variation. But more variation within the residency than between residencies.
 
TrashPanda13 said:
Applicant Summary
Board scores: 220s/250s
EM rotation grades: Honors/Pass (P/F only)
AOA: No
Medical school region: Southeast
Anything else that made you more competitive: Not really.

Main considerations in creating this ROL: Couples matching so below is my "singles" rank list and differs a bit from what I ended up putting on NRMP (Sorry, program directors...). Didn't apply to 4-year programs. Didn't apply to ultra high COL areas (no CA/NY/Boston). Fit was the single most important thing to me, as was what I felt to be a humane shift schedule. Didn't really care about how much I got along with the residents unless they were outright weird, but I cared a fair amount about how much I vibed with the PD. Moonlighting was pretty important to me. Low COL was important to me. Urban patient populations + county-style were a plus.

1) VA -- Virginia Commonwealth University (VCU)
This is my home program and I didn't find anything on the interview trail that would convince me to move. Dr. Moll is the best, and VCU is a great mix of urban patient population in an academic setting. Great moonlight opps, great place to live, 3 years of 18x10hrs shifts.

2) SC -- Palmetto Health Richland
I actually like Palmetto for a lot of the same reasons I liked VCU. Dr. Cook was awesome. Their shift schedule is very humane (though a lot of 12's early on in training). Great moonlighting opps. Columbia is a solid southern city with lots of nice places to live for very cheap. I liked the county-vibes that Palmetto had. Benefits were AMAZING and it's clear this group has a lot of money to throw around, which was a plus.

3) NE -- University of Nebraska Medical Center
What a surprise this was. Everyone on interview day was amazing from intern to program director. It's clear people are very happy here. Salary and benefits were really good, especially for Omaha, which is a great midwestern city. With the relocation of Creighton, UNMC now gets a lot of the more urban-omaha knife and gun club stuff, so they get exceptionally well rounded training now (see urban, rural, and wealthy all at the same hospital). Definitely still a little less poppin than the ones I listed above, and moonlighting was basically non-existent here which was tough for me.

4) OH -- Case Western Reserve University/University Hospital Cleveland Medical Center
Amazing faculty that has done a total 180 on their program in the past few years. This is a program on the up and up with THE most enthusiastic leadership team I found on the trail. They also recently got trauma center certification and are now stealing good cases away from MetroHealth at a pretty good clip. I felt that this was pretty on par with UNMC except that I'd rather live in Omaha than Cleveland, and the program was still working out a few bugs in the system, so to speak. Moonlighting was abysmal (something like $60/hr to work in the ICU. Pass.

5) FL -- University of Florida - Gainesville
Solid academic program with good name recognition. Dr. Beattie was a gem, and I could tell people were happy there. Honestly this is a program I'd be happy at, but just didn't really speak to me on interview day. Nothing really good or bad to say about it.

6) VA -- Eastern Virginia Medical School
This was a hard program for me to rank, because my couple's match interviewed here first and got asked some uncomfortable/borderline illegal questions (not EM) so it kind of biased me going in. With that said, I loved Dr. Knapp, and actually pretty much everyone else I met. Norfolk isn't my cup of tea, but also isn't the worst place in the world to live. Wouldn't be sad or happy to match here.

7) VA -- Carilion Clinic - Virginia Tech Carilion Emergency Medicine Residency
Roanoke was my favorite place to visit on the interview trail. If you are into the mountains, it's literally a perfect town. The residency seemed really strong, and the residents seemed like they liked their program a lot. With that said, I thought the salary and benefits were a little rough. I didn't vibe that well with the PD during the interview. I also felt like I'd miss the urban patient population a bit by going here.

8) TX -- John Peter Smith Health Network
Excellent county-style program. Actually most everything I wanted in a program objectively. The residents were happy and well trained. It seemed like wellness was actually taken seriously here. I didn't like how the interview day was structured. It very much seemed like it was designed to "score" me rather than get to know me as a person. I also am not a huge fan of Texas, which I figured out when I visited. Everything just seemed dead. I liked it a whole lot better than UTSW (lower on the rank list).

9) NC -- East Carolina University/Vidant Medical Center
Insane volume and pathology. Greenville is truly in the middle of nowhere. I like smaller cities, but even I have my limits. The PD was very polarizing but I loved his sense of humor, especially towards the ridiculousness of the process. Salary and moonlighting were on the lower ends. The residents didn't have access to dictation software/devices?

10) LA -- Louisiana State University - Baton Rouge
Seemed like a real knife and gun club with huge amount of resident autonomy. I jived with the PD. Moonlighting rates are insane in that part of the country. Baton Rouge was not my ideal city, and the traffic was surprisingly terrible for how spread out it was. I think a big negative was their lack of Ob/gyn exposure since their main hospitals basically sends out those cases (old school catholic hospital). That really dropped it hard for me.

11) VA -- University of Virginia Health System
Got along well with the PD and the faculty. Charlottesville is a nice city with a lot to do, but it's congested and relatively expensive for a the part of the country it's in. I think the biggest things that dropped it lower were lack of urban patient population, and salary and benefits being low compared to COL.

12) FL -- University of Florida - Jacksonville
This is where my list starts to get into programs I would be less than happy to match at. UF Jax is an AMAZING program that would probably be at the very top of my list if they didn't work their residents into the ground. I knew it would be ranked low the moment a resident at the dinner told me intern year they work 21 shifts per block that are about 13-14 hours by the time you get out. That's just not what will make me a happy and successful resident.

13) TX -- UT Southwestern Medical Center - Dallas
Great name with a frankly massive medical center. That's where the pros end for me. I got the feeling that EM got a little pushed around with respect to the other "big dogs" on campus. Dallas was way too big and crowded for me. The residents also seemed to be very lukewarm on their program director. OK -- University of Oklahoma College of Medicine/Tulsa This program was okay all things considered, but I couldn't get over the fact that their main training site was a level 3 trauma center when there were level 2 trauma centers in town.

14) GA -- Medical College of Georgia (MCG)
The residents seemed very overworked with a high shift burden. I didn't vibe with the PD that well. I thought Augusta was not a very nice town. On the plus side the moonlighting rates were out of control good.

15) PA -- Drexel University - Philadelphia
Honestly I really really didn't want to live in Philadelphia and it clouded everything else on interview day. As I've gotten a little older I've really become big-city averse. I'd be miserable holing up in an apartment for 3 year of my life after living in a house for the past 4.

Anything else to add?
I don't think a single program I interviewed at was "bad." and I ranked them all knowing that at the end of the day I would be a good EM physician no matter where I trained. Good luck to everyone who reads!
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Having lived in both Omaha and Cleveland (for at least two years in each place), I would much rather live in Cleveland again. Lots more to do in Cleveland, COL is similar, lake Erie regulates the temperatures a lot and provides some amazing recreation, commute times for me were always similar to Omaha. I think they're both underrated cities, but I would gladly live in Cleveland again. It would take a lot more for me to live in Omaha again.
 
Mr. Hat said:
Applicant Summary
Board scores: 290s/290s
EM rotation grades: Honors/Honors/Honors/Honors/Honors/Honors/Honors/Honors/Honors/Honors/Honors
AOA: Yes
Medical school region: Northeast

Main considerations in creating this ROL:
I need a place that's super baller that's going to make me into a true baller emergency physician

1) CA -- Los Angeles County/University of Southern California Medical Center
Absolutely legendary training, legends that are sung of in songs. Such baller legend training that I know I could become a legendary ER doc. The residents were hard core baller, like I'm pretty sure they could teach Jesus a thing or two about healing. And did someone say sunshine?

2) CO -- Denver Health
I was blown away, like this is such a baller place with a legendary reputation. When I was there interviewing they had 20+ year community attendings sitting in a room listening to interns teach, and they all said these interns could be attendings tomorrow. One thing to bring up that you might not know though, is they work hard and play hard so just be aware.

3) CA -- Alameda Health System - Highland Hospital
These were the chillest residents I baller'ed with during any interview. It's clear they work super hard but man do they know how to have fun. Super sick patient population, I mean like super sick. Baller super sick.

4) CA -- Los Angeles County - Harbor-UCLA Medical Center
Such a sick patient population, insane, like this is some seriously baller training. I know I would come out of here as a world class ER doc, but I couldn't get over how they gave me a blue coffee mug when I asked for the gray one.

5) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
What else can I say? Legendary. Docs come out of here super prepared to be ballers. I watched an intern manage a 200 patient mass casualty incident by themselves. However you would think that they would have let interviewees actually meet this Ronald Reagan guy which they didn't, so that was disappointing.

6) TN -- Vanderbilt University
I can't even. Like I just can't even. Like how can I begin to describe the legend that this place is. This is the place that made and defined the term baller. I liked the PD better than my own family, and this would be the most amazing baller place to train. But the cafeteria was a little pricey and I don't like country music.

7) MA -- Harvard Affiliated Emergency Medicine Residency at Beth Israel Deaconess
I really wanted to like this place. Super high acuity and sick, sick, sick, sick patients with the Harvard name. Can you imagine saying you're a Harvard grad? Baller. But I didn't quite click with the residents and they only crack like 20 chests per day which just doesn't cut it. Still would be honored to train here and think I would come out pretty baller.

#8-45 -- Other places that ranged from baller to semi-baller to mini-baller to no-baller. But I figured that with only 290's on the steps and my 11 honors, I really needed to interview plenty of places. It would just be an honor to train in EM and work with all of you ballers.


Anything else to add?
Super grateful for all of these interviews and like just humbled beyond humbled man

Applied to: 110 total
Interviewed at: 45
Declined interview: 64 (it was getting a little pricey)
Not offered an interview: 1 (Medical University of Rural North Dakota)
Click to expand...

EM ROL thread cliff notes
 
The rank tally list on the spreadsheet this year is much more interesting than these ROLs. More people should fill that out.
 
Spagett! said:
This thread is super useless this year. There's pretty much zero fresh discourse regarding merits of various programs. It's just a doximity 'bate-session.
Click to expand...

Pam_Beesley said:
People complain that nobody is posting ranklists. Then, people start posting rank lists, and people complain that it’s too boring and all the same programs. 😕
Click to expand...

I tried to add some flavor to this year :\
 
Applicant Summary
Board scores: 240s/240s
EM rotation grades: Honors/High Pass
AOA: No
Medical School region: Southeast
Anything that made you more competitive: Who knows

Main considerations in creating this ROL: Gut feeling, resident happiness, overall culture/philosophy of program, prefer big city over smaller town, wanted a program that would open all doors for me as I am unsure of what I want to do (academics vs. community)

most of these comments were random notes I took during the interview day or thoughts right after interviewing

1) TN -- Vanderbilt University
Pros- I loved this place, residents were fun and extremely nice, felt like my people, PD and chairman really care about the program and would go the extra mile to advocate for the residents, Nashville is great, moonlighting encouraged, shifts 8+1, longitudinal VA, airway lab anytime, 5 blocks ICU, 2 weeks peds anesthesia, 3+1 mentality, full month intern orientation, **emphasis on teaching

Cons- questioned the volume and patient diversity (in comparison to the other programs I interviewed at) but ultimately decided it wasn't a problem/factor

2) IL -- McGaw Medical Center of Northwestern University
Pros- I had a great gut feeling here, loved the interview day and didn't get the elitist vibe, seems like they take the 'we are family' thing to heart, amazing reputation, graduates can do whatever they want and are all over the country, training sites diverse, 8.5 ICU blocks, graduated responsibility with PGY3&4s as junior attendings, CHICAGO!, MBA program @Kellogg

Cons- Chicago COL, winters, community sites far, maybe too much seminar/didactics?

3) PA -- Temple University School of Medicine
Pros- Residents were fun and seem genuinely happy, APD's and PD ate lunch with us and were very easy to talk to/laid back, close knit group, great reputation nationally, graduates go all over nation, EM very well respected in the hospital, awesome trauma experience, diversity of training sites, county/underserved patient population, Philly would be fun

Cons- maybe less academic options than above two programs

4) CA -- Alameda Health System - Highland Hospital
Pros- obviously an EM powerhouse, I had great conversations with all my interviewers, unopposed residency where seems like residents basically do it all, graduates can work anywhere, international medicine*, small number of faculty, residents seemed like a good group, fantastic ultrasound training, residents doing nerve blocks, good ortho and OB experience, month off at the end of intern year

Cons- Oakland COL with small housing stipend, Oakland is not as fun as SF

5) CO -- Denver Health
Pros- phenomenal clinical experience and volume, 50/50 academic & county, graduated responsibility with R4s running entire DG department and R3s running the show at UofC, great gut feeling during interview day although they stressed how much they worked over and over again, strong didactic curriculum, Denver is awesome, access to a lot of activities

Cons- attended M&M conference and it was significantly more formal than any other conference I attended, really feels like an EM program with a surgery personality, the residents and faculty do stress how much they work but they love it, at the end of the day- I loved the training/curriculum at this program and feel like I would be a total badass EM doc but just didn't feel like it would be as good of a personality fit as the above programs.

6) IN -- Indiana University School of Medicine
Pros: 400 graduates, Eskenazi + Methodist + Riley, go anywhere and do anything, laidback residents and faculty, intern orientation month, R3 teaching shifts, ED shifts 9 hours, 6 ICU blocks with single converage on nights, Indianapolis cheap COL, both Eskenazi and Methodist >100,000 volume, integrated peds at L1 hospital, R2 and R3s same schedule thus easy shift trades\n\nCons- Indy seems like an OK city, not as fun as Chicago or Philly if I'm going to be dealing with the cold"}">Pros- >400 graduates, Eskenazi + Methodist + Riley, go anywhere and do anything, laidback residents and faculty, intern orientation month, R3 teaching shifts, ED shifts 9 hours, 6 ICU blocks with single converage on nights, Indianapolis cheap COL, both Eskenazi and Methodist >100,000 volume, integrated peds at L1 hospital, R2 and R3s same schedule thus easy shift trades

Cons- Indy seems like an OK city, not as fun as Chicago or Philly if I'm going to be dealing with the cold

7) TX -- John Peter Smith Health Network
Pros- basically an unopposed residency, county program, residents running traumas for half the day switching with gen surg residents from off site program, would be fantastic training with a ton of autonomy, full month EM orientation, family feel, everyone is extremely nice, night before protected for conference, didactics led by attendings, EMRAP meetings instead of Journal Club

Cons- Name and reputation not as strong as I would like (I could be completely wrong about this having an effect on job opportunities post residency) otherwise love it

8) NC -- University of North Carolina
Pros- I really wanted to rank this program higher but I couldn't see myself loving Chapel Hill, solid three year program, all the right feels on interview day, awesome preinterview dinner, really fun residents, smaller program, female leadership, diversity of training sites, WakeMed seems like a great place to train, cheaper COL

Cons- commute to different sites is long, benefits not very good, far from airport

9) TX -- University of Texas Houston
Pros- best residents, most fun pre-interview dinner, newly added community experience at other MH hospitals, busiest L1 trauma center in country, a ton of autonomy, faculty that seem to care about bedside teaching, pathology at both LBJ the county hospital and Memorial Hermann complement each other, new trauma institute soon

10) TX -- University of Texas at Austin Dell Medical School
Pros- residents really well taken care of with best benefits I saw, diversity of training, Austin is one of my favorite cities in the country, the PD is amazing and hilarious, he seems to really care about the residents input/feedback and about them as individuals (thus wants to keep it a small program), 18 shifts per month all with one hour overlap, QOL here would be unreal

Cons- unsure about how great clinical experience is and if will get enough volume or acuity, privately owned residency program

11) TX -- UT Southwestern Medical Center - Dallas
Pros- well known established program in Texas, had a good time at the pre interview dinner, New Zealand elective, solid 3 year program, Dallas is fun city with low COL

Cons- just wasn't feeling it

12) CA -- Los Angeles County/University of Southern California Medical Center
Pros- loved my day here, I think the curriculum is top notch and the graduated responsibility resonated with me, ED has all procedures, strong didactics (EMRAP influence), jail ED experience, cadaver lab available to you at all times, amazing reputation, PD is invested in residents and resident wellness, similar to Denver in that I think probably the best clinical training

Cons- LA traffic BLOWS, I mean really sucks and this is from someone who has experienced it firsthand for years, COL is really high and not a fan of the people of LA, works mostly 12s all 4 years

13) IL -- John H. Stroger, Jr. Hospital of Cook County
Pros- Another well established and well known program, graduates can essentially go anywhere they want, enjoyed dinner with residents and candid/laid back interviews, awesome trauma experience, graduated responsibility, now longitudinal pediatrics experience, diverse training sites (multiple community months), mission of service to the patients of Cook County, 8 hour shifts with hard signout, Chicago is awesome with so much to do

Cons- Wanted to love it more but just wasn't feeling it. COL is high and salary not the greatest, 2 months of internal med floor, residents seemed slightly tired/overworked, a lot of change up ahead (interim PDs currently)

14) GA -- Emory University School of Medicine
Pros- Grady Memorial, Atlanta, strong didactics and amazing reputation, big on diversity, faculty committed to teaching, very busy trauma center, EM well respected in hospital, Dr. White is awesome, access to Emory U resources

Cons- wasn't feeling it

15) CA -- University of California San Francisco - San Francisco General Hospital
Pros: academic/county split, easiest and most laid back interview day of the entire interview trail, dinner was fun, great experience at Zuckerberg, "areas of distinction" provides structured mentorship, really emphasized resident wellness, awesome off service rotations, San Francisco would be a really fun, new adventure

Cons: SF is fun but the COL is ridiculous even with $12K stipend & most residents have to live with roommates, didn't really sell the fourth year very well, unclear graduated responsibility, anesthesia shares trauma airways, just didn't feel it was a good fit


Applied: Alameda Highland Hospital, Carolinas Med, Cook County, Maricopa, Denver, Duke, Emory, Indiana, Jackson Memorial, John Peter Smith, LAC+USC, LA county Harbor UCLA, Northwestern, Medical College of Georgia, MUSC, Oregon Health, Orlando Health, Temple U, UCLA Oliva View, University of Alabama, UC Irvine, UC San Diego, U of Chicago, UCSF San Francisco General, UT at Austin Dell, UT Houston, UT Southwestern, U of Washington, Vanderbilt
Declined: UC Irvine, UC San Diego, LA County Harbor, Orlando Health, Medical College of Georgia, MUSC, Jackson Memorial, Duke
Rejected: U of Washington, U of Chicago, U of Alabama, UCLA Olive View, Oregon Health Carolinas Med, Maricopa
 
Applicant Summary
Board scores: 210s/240s
EM rotation grades: Pass/High Pass/Honors
AOA: No
Medical school region: Midwest
Anything that made you more competitive: Strong SLOE from visiting rotation

Main considerations in creating this ROL: Couples Match

1) CA -- Los Angeles County/University of Southern California Medical Center #1 for both me and my partner
2) CA -- Kaiser Permanente San Diego Medical Center
3) CA -- University of California San Francisco/ Fresno
4) AZ -- University of Arizona
5) TX -- UT Southwestern Medical Center - Dallas
6) CA -- University of California San Diego
7) CA -- Kaweah Delta Health Care District
8) IL -- University of Illinois Hospital - Chicago
9) Loyola University - IL, not listed
10) FL -- University of Central Florida/HCA GME Consortium of Greater Orlando
11) CA -- Arrowhead Regional
12) IL -- Presence Resurrection Medical Center
13) NY -- New York-Presbyterian - Queens
14) MI -- University of Michigan
15) IL -- Rush University Medical Center
16) MI -- St John Hospital & Medical Center
17) MI -- William Beaumont Hospital
18) FL -- Brandon Regional
19) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
20) MI -- Sinai-Grace Hospital
21) CA -- Kern Medical
22) GA -- Wellstar Kennestone
23) NV -- Sunrise Health GME Consortium

Anything else to add? I have a ton of ranks, I only listed the programs in order that they popped up on my list. This list was made mostly with couples match in mind and entirely on feel - reputation and prestige of program was not a priority for me.

Applied to:I applied to 90 programs, I can't even list them all Albert Einstein Philadelphia, Baylor, Henry Ford Macomb, Henry Ford Wyandotte, Jackson Memorial, Kendall Regional UNLV, Wyckoff Heights, Brookdale University, Lincoln Memorial and Mental Health center, Riverside Community Hospital
Interviewed: All Ranked above, plus Kern, Wellstar Kennestone, Sunrise Health Las Vegas - all ranked, I just ran out of spots on the survey
Declined: None
Rejected: Northwestern, Emory, UT Austin, Stanford, UCLA Harbor, NY Presbyterian, Temple, Denvery Health, Oregon Health, University of Washington, University of Pennsylvania, University of New Mexico, University of Chicago, UCLA Olive View, Loma Linda, University of South Florida, Ichan School of Medicine
 
Applicant Summary
Board scores: 210s/250s
EM rotation grades: Honors/Honors/Honors
AOA: No
Medical school region: West coast
Anything that made you more competitive: I got 2 top 10% SLOEs and a top 1/3. Honored most of my third year clerkships. I think my improvement on Step 2 helped a lot and it was brought up at several interviews. Other than that I was a pretty generic candidate. Some volunteering, lots of tutoring and teaching.

Main considerations in creating this ROL:
Location
Opportunities for niche development (want to stay in academics)
Fit and warm fuzzies on interview day
Decided I really didn't want a county program. It's just not the fit for me I think. Also same with 12's. I feel like those are best avoided.

1) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: This place just kind of had it all for me. It's close to home, I love the area, the interview day was great, and I left just feeling like they would make me into the kind of doctor I want to be. Really liked the faculty and residents I met.

Cons: COL, but honestly that's almost every program on my ROL

2) CA -- University of California San Diego
Pros: LOCATION. San Diego will always be my hands down favorite place on this earth. While this place may not have the most rigorous training on my list, my overall happiness living there makes up for it for me. I've done enough delayed gratification and want to actually start building myself a life that's not temporary. I also had a fantastic time talking to all the faculty I met. I think the PD is fantastic (although I can see why she might rub people the wrong way) As a diver, the hyperbarics stuff is a real bonus. I like the variety of sites they rotate at as well.

Cons: Trauma situation is funky but I DGAF honestly. Lunch sucked.

3) DC -- George Washington University
Pros: This was another place that just gave me really good vibes. I loved Dr. Roche and all the faculty. They have a lot of unique opportunities for niche development and holy **** do I want to work on the hill as a 4th year. I had a blast at the social and really got along with all the residents I met. DC is a great city and I'd get to keep my car.

Cons: Less trauma than some other major cities

4)CA -- University of California Irvine Medical Center
Pros: Loved this program top to bottom. Great faculty, great location, awesome residents who I think I'd fit in well with. Huge focus on med ed which is my jam. They run 2 EM journals out of their department and they are massively imbedded with the medical school which means even more teaching opportunity. The residents seemed really really happy. Social event was awesome.

Cons: Lower volume, although the PD makes a good case with some math that it really is sufficient numbers per resident. Only 1 month of elective time and because I know who I am, I will 100% just end up doing my month on Catalina and never really spend time figuring out my niche.

5) RI -- Brown University
Pros: Excellent reputation with a huge catchment area. Sees well over 100k per year and on my tour it was one of the busier EDs I saw all season. I LOVED the PD. And most of the faculty I met were really great. Possibly my favorite social event of the season and residents seemed to really love the program and even living in RI. Spoke with a couple fellow west coast natives who had never been to RI before their IV (just like me) and were loving residency there. This was another one of those programs that seemed to have endless resources and opportunities.

Cons: Providence is not exactly the "large east coast city" that I had in mind, but the food is good and really that's all I need. Plus it's got beaches and that makes up for a lot. One super awkward interview that ended like 10 minutes early cause he just kept asking if I had any questions and I ran out of questions.

6) NY -- NYU/Bellevue Medical Center
Pros: Amazing program. I've never heard anything bad about the training at NYU. They have some genuine EM badasses there and I think they have the best mission out of any program I interviewed at. I also love the city and have always wanted to live there. I also loved the PD. I think his vision for the program is gonna pan out well. Good mix of academic, safety net, and now a new community site in Brooklyn.

Cons: COL, a couple awkward interviews.

7) CA -- Kaiser Permanente San Diego Medical Center
Pros: Location. Already talked about how I love San Diego. Only reason this isn't higher is cause I just couldn't justify putting it above some of the other places that I think will give me significantly better training. I wish I was more confident in their acuity and volume because I loved the faculty and residents and felt like it would have been a good fit otherwise.

Cons: Low acuity, low volume. Not sure how training at a kaiser might work out and don't really see myself in the community/being part of the kaiser system forever. No affiliated med school, basically no opportunity for niche development.

8) OR -- Oregon Health and Science University
Pros: Felt totally comfortable here. Love Portland and thought the program would give me sufficient training with supportive faculty and co-residents. And anyone NOT like the PD? Big focus on med ed. Opportunities for wilderness med. 3 years but didn't seem like it was super crammed and the residents were all really happy and super excited to talk to all the applicants about the program.

Cons: Lower volume, lower acuity.

9) TX -- UT Southwestern Medical Center - Dallas
Pros: Great reputation, massive ED with insane volume. Would get excellent clinical training but not much else.

Cons: Meh about the residents and faculty. Had 1 interviewer start ragging on liberals and gun control and it was a bit of a turn off for me. Most faculty I asked about why they like UTSW said something about the research funding from the hospital and liking Dallas. I'd prefer if they said something about the residency.

10) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
Pros: Crazy insane volumes, lots of trauma. No doubt the residents are amazing doctors. Lots of really cool and groundbreaking research coming out of that program. Residents were really cool. Hyperbarics.

Cons: Bronx. PD was weird. Almost all 12's. Residents seemed TIRED. At the end of the day, just didn't see myself fitting there.

11) DC -- Georgetown University Hospital/Washington Hospital Center
Pros: Solid program in a city I like a lot.

Cons: Didn't vibe with some of the residents. And honestly, just nothing stood out to me as being special or being a good fit. I don't think there's anything wrong with the program, just wasn't for me.

12) CA -- University of California San Francisco/ Fresno
Pros: really great training. Get to park in the ambulance bay. I guess that's cool?

Cons: I really disliked this program. At the social, the residents were super weird and not friendly. On my interview day, I interviewed with an intern as 1 of my 3 interviews and the second IV was with a faculty member who was new to the program and really didn't know much. PD seemed to be barely listening while I was talking. Fresno is a garbage town. I left here angry at the money and energy I spent to get there.

Addendum:
Rereading my Fresno comments I feel kind of bad. I was probably exhausted and cranky that day which colored my whole opinion. It seems like it's probably a great program, I just had some hella weird interactions and it just really was not a good fit for me


Anything else to add? During interviews, I took all these detailed notes and made charts and was all organized and then when it came down to ranking a lot of it was based on gut feeling. I literally took flashcards with program names on them and moved them around until it was an order that felt right. In hindsight, I way over applied. I was just really convinced that my Step 1 was gonna hurt me a lot and that my application was too boring. I am still amazed at some of the interviews I was offered and could not be happier with how everything turned out.

Applied to: Way too many
Declined: University of Arizona - South Campus, Kaweah Delta, Arrowhead Regional, Desert Regional, St. Joseph's, Kern, Loma Linda, Johns Hopkins, UNLV, Lincoln Medical and Mental Health Hospital, Hofstra Staten Island, New York Presbyterian, Mount Sinai St. Luke's Roosevelt, Maimonides, SUNY Brooklyn, New York Presbyterian - Queens, Penn, Stony Brook
Interviewed at: All ranked
Rejected: UCLA Olive View/Ronald Reagan, UCLA Harbor, USC, Highland, UC Davis, Denver, Northwestern, Rush, Cook County, BU, HAEMR, BIDMC, Maryland, Mount Sinai, Temple, UT Austin. Was also ghosted by JPS, Drexel, Thomas Jefferson, Rutgers, Yale, Maricopa, and University of Arizona
 
Applicant summary
Board scores: 230s/240s
EM rotation grades: Pass (P/F only)/Honors
AOA: No
Medical school region: Southeast
Anything that made you more competitive: Only did 1 away but was told it was top 10%. Good grades I suppose, but not AOA.

Main considerations in creating this ROL: Reputation, how long program has been around, city, weather, fit. The final rank list was a weird amalgamation of all of it. Also 3>>>4 for me, maybe too much emphasis on this.

1) MN -- Hennepin County Medical Center
Pros: Legendary program, really liked the mentality of the "ED does it all and is in charge." Tons of clout in the hospital. Really liked the old guy who came in and talked about how we already made a great decision becoming ED docs. Seems like all doors open and a 3 year program to boot. Minneapolis seems to have rave reviews and I'm curious, family nearby,

Cons: Way too cold and it makes me nervous. Start very early, residents seems cool but tired. Love how much they do in the ED, but realistically won't be doing that if I go out to the community after.

2) AZ -- Maricopa Medical Center
Pros: Excellent established program, happy residents, felt a good fit with this group. Good reputation from everyone I talk to, COPA is a known name in EM. I prefer hot to cold, like to hike, COL seems cheap. They group nights, and have tons of elective time. Best lunch hands down no contest GG.

Cons: Residents married/older and I'm single. Not sure Phoenix has great dating scene from my google searches. Some concerns about off service rotations and competing trauma centers but honestly not worried about that, seems like PD is in the business of optimizing things. Some thoughts on spreadsheet Copa is on the decline but didn't get that impression at all.

3) TX -- UT Southwestern Medical Center - Dallas
Pros: County and established, I believe and have heard many times "Best in Texas". Being doc in Dallas is awesome, lots of $$$ job opportunities after. Liked residents, seemed happy. Like the idea of training at Parkland. Good peds seems like.

Cons: Relationship with trauma for sure. Worried about too many consults and being overshadowed by other specialties but the volume at Parkland alleviates this. Weird PD interview, program seems a little big for standardization.

4) IL -- Advocate Christ Medical Center
Pros: Reputation in EM especially in Chicago. Strongest department in hospital for sure. Reputation of being badass. Love Chicago

Cons: That commute if hypothetically living in South Loop scares me. Cold. Didn't really get a chance to vibe with residents. Worried reputation is more regional than national. It's petty but outside of EM no one has ever heard of it and Advocate-Christ doesn't exactly roll off the tongue.

5) NY -- Mount Sinai St. Luke's Roosevelt Hospital Center
Pros: Happiest residents, wellness oriented, being able to try out Manhattan which will realistically never happen again.
Cons: Worried "too cush", worried procedure numbers and acuity is lower than I'd like. COL nuts.

6) IL -- University of Illinois Hospital - Chicago
Pros: Love Chicago, really like the idea of working at diff sites even the commute would be killer. Very established-Browncoat nation seems real. Loved the residents.
Cons: Sort of the middle child of Chicago. Better than Rush and Presence but not as legendary as the others. Cold.

7) CA -- University of California San Diego
Pros: Best location by far, happy residents, flight seems cool.
Cons: I really prefer 3>>>4. Some concerns about acuity. Would prefer clinical emphasis over academics.

8) OH -- University of Cincinnati College of Medicine
Pros: Best program on my list. Awesome PD, incredible badass program. Honestly curriculum is excellent and would set me up for a career doing whatever. PC is also on the ball and talk about interview swag.
Cons: Cincinnati-I'm single and better places to spend late 20s. Again for me 3>>>>>4. I would have a hard time working the fourth year when I could be done already paying off my stupid amount of loans.

9) CT -- Yale New Haven Medical Center
Pros: More resources than you can shake a stick at. Seemed clinically strong not just a research program. Yale name. Best benefits by far on trail.
Cons: New Haven is a tough sell. 3>>>>>>4. Cold. Not as good as Cinci.

10) DE -- Christiana Care Health Services
Pros: Badass program, liked faculty and residents. Cluster nights. Good pay
Cons: Middle of nowhere cold. If this program were in a different place would be top 5.

11) OH -- Ohio State University Medical Center
Pros: Columbus surprisingly awesome. Beautiful hospital. Good reputation in EM
Cons: Too academic for me I think. One APD too intense, the other made me feel uncomfortable with his standard questions. Low salary.

12) SC -- Medical University of South Carolina
Pros: Charleston is sweet. happy residents, Liked the PD.
Cons: Too small? worried about acuity.

13) WI -- University of Wisconsin
Pros: $$$$$funded. good curriculum. Liked PD. Beautiful hospital. Family nearby.
Cons: Madison cool if weren't single. Cold.

14) TX -- University of Texas Houston
Pros: Established, being a doc in texas is good. I like Houston.
Cons: Didn't vibe with the residents at all. One was super tired and disgruntled and was a total change from my other interviews. A different one was "too quirky" and I couldn't see myself working a shift under them. (I like quirky, but not this quirky)

Declined: UVA, JPS, Duke, WashU, UF-Jax, UT-Austin, UT-SanAntonio, USF, Miami Beach, Louisville, UAB, Denver
Interviewed: See list
Rejected: LA-USC, UPMC, Indy, ORMC, UNLV, Kaiser-SD, UChicago, Wake, UNC, Carolinas, Vandy (bummed), MCW, Iowa, NYU, BU, Brown, LSU-NO, Utah, Oregon, Temple, Emory (bummed)
 
Applicant summary
Board scores: 220s/240s
EM rotation grades: High Pass/High Pass/High Pass
AOA: No
Medical school region: East coast
Anything else that made you more competitive: Non-traditional student (significant work and volunteer experience prior to med school, came up in every interview)

Main considerations in creating this ROL: Fit/gut feeling (I tried not to overthink this part); Location (prefer less urban, lower COL areas); Strong pediatric experience

1) VA -- University of Virginia Health System
Honestly, my top 3 are really all tied in terms of that feeling of "fit", but UVA ended up at the top mostly because of (really minor) little negatives I could identify at #2 and #3. This is an incredibly solid program in a great area - Charlottesville may not be everyone's cup of tea, but it's definitely my kind of town. I really got a good feeling from both the residents and the faculty. Everyone seemed really enthusiastic. They've got a new PD, but she's been with the program for years, and it seems to have been a very smooth transition. Their peds experience seems really strong; I wasn't quite sure what to make of the "peds surgery" floor month, but the residents seemed to have found it really helpful in managing sick kids (or they were really good BS-ers on interview day, but I guess that's a danger anywhere).

Bonus points - best interview lunch on the trail (seriously, after week after week of sandwiches/wraps/fried food, that make-your-own salad bar was glorious).

2) KY -- University of Kentucky
I left UK completely in love with both the program and the area. It's a little more academic than I thought I was looking for, but the faculty and residents completely sold me. The area is a perfect mix of a slightly urban center with tons of rural areas surrounding it. I was a little surprised at the amount of traffic in the area, but I guess no place is perfect. They're very strong on US (they've got both Matt Dawson and Jacob Avila on faculty), and have a strong longitudinal peds experience. They admitted to some struggles with working well with the ortho team, but seem to be making progress in that area.

This program sat at #1 on my list off and on right up until I certified; ultimately, I'd be thrilled to match here, but dropped them to #2 because I felt like the residents at UVA were a bit more "my people" than they were here (not to say I didn't get along with these residents, just didn't quite click as well). Also, they flat out admitted that the surgery floor month exists for political reasons, which would be a little annoying.

Bonus points - they own a castle. Seriously, a group of UK docs bought a castle just outside of town. They host an US competition there, and have the ED holiday party there too.

3) TN -- University of Tennessee College of Medicine at Memphis
Procedure-heavy training at a place that sees sick, sick patients. The residents I met were awesome, and the faculty all seemed great. Supposedly they have an awesome SIM center, we got to see pictures but not the actual thing during the tour. Only place I interviewed where every single faculty interview felt like a good fit, no moments of awkwardness that stuck in my memory. I walked out feeling like I'd be incredibly happy here, and I'd be very excited to see "Memphis" on that letter when I open my envelope in March.

Again, putting it at #3 came down to some small things, and one kind of important thing to me - they don't have very many women on faculty. A certain program further down my list talked themselves in circles trying to make it sound like that wasn't a big deal when I asked about it, but at Memphis, they owned it as an area for improvement. Apparently they have several new hires coming on that will bring those numbers up, and I really appreciated their honesty. Also, they've got a medicine floor month, which I'm not super thrilled about, but apparently they've considered dropping it and the residents basically split down the middle on whether to do that or not, so it stays for now.

Bonus points - they have a Bass Pro Shop with a hotel, a bar, and alligators. This might not be exciting to everyone, but I'm that kind of girl.

4) SC -- Greenville Health System
I loved the people at this program so very, very much. Dr. Pfennig is amazing. Seriously, the people at this program were so strong that it didn't feel like a new program at all. Pretty much all the faculty are there because they wanted to be part of the residency, and everyone was very enthusiastic about what they had to offer. They alternate trauma airway with surgery, which is a little weird, and maybe speaks to some institutional politics that are still sorting themselves out. Overall, the residents seem really strong and very happy with their experience here. There were one or two who seemed a bit standoffish, but overall most were awesome. I think if I were making this list in 3-4 years and could see a solid alumni network, I'd be tempted to bump this up into my top 2.

Bonus points - the coffee shops in Greenville are amazing. Seriously, I'd probably smell like coffee all the time if I lived here because I'd spend so much time in them.

5) PA -- Geisinger Medical Center
I definitely think they dose the water here. Went in very neutral on the program, walked out loving it. Great residents, great faculty. They know they've got an uphill battle location-wise, and they do a great job reaching out to applicants to make them feel valued after interviews (personalized notes in the mail, holiday cards, phone call at rank time). I actually was surprised how much I liked the Danville area - definitely very, very small, but plenty going on in the greater region and the area itself is beautiful. Upon reflection after the initial post-interview buzz wore off, I think the program might be a bit too EMS-heavy for my personal preference, but overall I think I'd really like it here.

6) NC -- East Carolina University/Vidant Medical Center
I went back and forth so many times about where to place this program. I had a really positive experience on interview day. Great faculty and resident interviews. The PD seemed to have gotten a bad rap in prior years' ROLs, but I got on great with him. Residents all seemed happy with their training. This Greenville was much cuter than I had expected. It doesn't have all the particular extracurriculars I was looking for, but I think I could be happy there. Overall, great program that I think I could really enjoy. If Greenville were a little closer to either the coast or some of the bigger NC cities, it would have been a much easier sell.

7) PA -- St. Luke's University Health Network
Such a great interview day. The "hidden gem" title used in previous years' ROL lists definitely still applies. Their PD is awesome, and the rest of the faculty I interviewed with were great too. There are a couple of faculty here who I'd come just for the chance to work with them. The residents overall seemed great, although I didn't really connect with a few of them, including the one who interviewed me (very quiet guy, a little awkward, maybe not the best choice to put forward on interview day - but maybe it was me). I don't love the idea of going down to Philly for peds. Bethlehem is definitely evolving as a city, but there was something about the area that was a little ho-hum for me.

8) PA -- Reading Health System
This program has incredible potential. They've got great faculty, incredible patient volume, and an expanding hospital network to work with. I loved the PD, and had really great interactions with most of the faculty who interviewed me. In a couple of years' time, this program might have cracked the top half of my list. I don't doubt that their residents will get great training, but like someone else posted earlier, I too walked away with some questions about whether the residents were really being pushed enough (one actually bragged to us about seeing only 4 patients one shift...I don't need a program to run me ragged, but I definitely want to be pushed at least somewhat). Maybe it's the benefit of one extra year, but unlike Greenville, this program definitely felt very new and I got the sense there'd be some serious bumps along the way.

9) NJ -- Hackensack University Medical Center
Really enjoyed my interactions with the faculty/residents here. They seemed very positive about their training and the opportunities they have. This is probably the most beautiful hospital I saw all season. I just can't get past the location. I’m sure it’s perfect for some people, but I want something a little less urban at this point. I don't want to pay $1800+ for a studio apartment, have to have roommates, or spend ages sitting in traffic. Beyond that, I really have a hard time thinking of any other negatives here; if it weren’t so urban and expensive, it would be in my top 4 for sure. I’ve heard talk of difficulty getting procedures, but asked multiple PGY3s and they all said they had everything they needed and didn’t know anyone who was struggling to get numbers (although they do admit some come from SIM).

10) PA -- Penn State Health Milton S Hershey
This program is kind of a weird one for me. It's a solid program and I'm certain I'd get great training here, but felt like I didn't really form any connection on interview day. I don't have anything overtly negative to say about my experience here, but nothing positive sticks out in my mind either. It's just sort of there on the list.

Bonus points - full-sized Hershey bars at the end of the tour. Way to embrace the chocolatey goodness. Also, they had a really cool free pen.

11) TN -- University of Tennessee - Nashville
I wanted to love this program so much. The location is perfect for me - close enough to occasionally enjoy the amenities of Nashville, but still have a reasonable COL in a smaller area (they really need to stop calling themselves Nashville, because Murfreesboro is definitely not the same thing). I loved the residents, I seemed to get along really well with them. Most of the faculty were awesome, although I got weird vibes from one or two of the ones that I met. However, I had what was probably one of my most uncomfortable interviews of the season with the PD. He came across as very confrontational and a bit condescending, and that interview totally shifted how I felt about my interview day in a bad way.

They certainly see a huge patient volume, and the residents all said they were having no trouble reaching procedure numbers. They really push their event medicine program, which doesn't really do much for me. I don't know how I feel about the idea of being one of only 2 residencies in the hospital - I can see the benefits, but I feel like you miss out on having other residents around to connect with and having attendings on other services who are actually used to teaching. I also don't love the idea of traveling several hours away for trauma and pediatrics.

Bonus points - one of the nicest program coordinators on the trail. That bag of snacks she left us with really came in handy when I got stuck at the airport for hours and hours on the flight back home!

12) PA -- Crozer Chester Medical Center
Another program I really fought to love, but just couldn't do it. I had some very positive faculty interviews here that made me want to love it, and overall, they're building a really solid program. Unfortunately, I don't love the area (I don't want to live in Philly, and I don't want to fight Philly traffic on a daily basis), and I didn't seem to connect well with the residents. Also, my interview day ran extremely late (we're talking hours late) because at least one faculty member was very late showing up and one of the residents who was interviewing left to go run an errand for an hour and a half in the middle of interviews. The whole thing felt disorganized, and pretty disrespectful of our time as applicants. And then I got stuck in rainy rush hour traffic because we finished so much later than scheduled, and now whenever I think about this program, my BP shoots up again.

13) NJ -- Rutgers Robert Wood Johnson Medical School
I've tried really, really hard to come up with positives for this program based on my interview day, but I had a generally bad experience here. Maybe it's just their style, but the faculty interviews were all very uncomfortable for me. They all seemed a bit standoffish and even confrontational. They were working from a set of questions rather than conversing, so maybe that contributed to the feeling. I also did not get good vibes from the residents, the few who actually showed up to the dinner and/or lunch were just very blah about their experience. I get it, you're tired, but if you can't even fake some semblance of enthusiasm for an hour or two, that tells me a lot about your program. Also, I really, really don't want to live in New Brunswick - all the headaches of urban living without the benefits of an actual major metropolitan area.

At the end of the day, though, I'd be an emergency medicine physician at the end of 3 years here, and that beats the hell out of SOAPing, which is why they're still on my list.


Anything else to add? As you can see, my interviews were all over the map. Interview season was exhausting, but full of fun and surprises - none of my top 3 would have been in my top 3 if I'd been making a list pre-interviews. I had a little trouble listing out specific pros/cons for the programs, because I kept a running rank list based on gut feeling that I adjusted after each interview, and essentially that became the list I certified, with only a few small adjustments. Ultimately, I'd be ecstatic to see any of my top 4 on match day, and very happy with any of my top 8.

Like many, I was surprised by some of the programs that invited me to interview - and by some that I thought I was a good fit for that didn't invite me. I definitely applied to too many programs, I knew it was too many when I was applying, but I just had no idea what criteria to use to cut the list down any further. I had hoped to get it down to at most 50, and had a final cut ready that I ultimately decided not to do...and I'm grateful I didn't, because all 3 of my top 3 programs would have been in that final cut.

Applied to: 65
Declined: None
Withdrew prior to hearing from: None
Rejected: Too many to list

Note from @TrashPanda13: Love the shout-out for the Bass Pro Shop in my hometown of Memphis. For anyone who hasn't been to Memphis, that Bass Pro Shop is literally a giant pyramid along the river. I still call it "the Pyramid" since that's what it was called before they plastered the Bass Pro Shop logo on the side of it. If you're ever in Memphis, I recommend checking it out just because of how ridiculous it is, and then go get some bomb barbecue.
 
Applicant Summary
Board scores: 210s/230s
EM rotation grades: Honors/High Pass
AOA: No
Medical school region: Southwest
Anything that made you more competitive: A good amount of leadership in the AMA and in my local ACEP chapter. Lots of research and publications before medical school that were talked about way more than I thought they would.

Main considerations in creating this ROL: Obviously fit with the leadership and residents, places my wife liked, support for families was huge as well as close proximity to family. A little bit of prestige because I am fallible and like thinking highly of the place I am training at.

1) AZ -- University of Arizona College of Medicine at South Campus
I loved this place so much. It had just about everything I wanted in a program, from the Spanish curriculum to the awesome program director. This was the first place that I went to that I called my wife after the residency dinner and told her "this is the one!". I doubt I'll match here though, because it seems like everyone that I talked to really enjoyed that program.

2) NM -- University of New Mexico
Arguably either the best or second best training available from the places I ranked. Crazy amount of pathology. Very cool residents who came to the dinner, along with 8 of their dogs. I had trouble between ranking this place number one or AZ-South number one. In the end it came down to fit, which I felt was just ever so slightly better at AZ south.

3) VA -- University of Virginia Health System
PD is an incredible person. They really make it a point to include families into the residency which was a huge plus for me. Charlottesville is such a fantastic city with a lot to do. The training seemed a little on the lower acuity side. Good peds exposure. Residents were very chill. Just an overall chill program that I felt I really vibed with.

4) TX -- Texas Tech Health Science Center/Paul L Foster School of Medicine
The most underrated program when talking with people who are familiar with the area. The residents are VERY happy. Seems like they do their own thing, which is fine. Didactics are reportedly not great. I honestly had no idea where I should put this program on the list. It is close to family for the wife and I, which is important. I really like border health. I do not like El Paso. In the end I put UVA above this one given I would be so much more excited to match at UVA than at TT-El Paso on match day.

5) ME -- Maine Medical Center
Probably best clinical training available of the programs on my list, second only possibly to UNM. Relatively unopposed residency. Portland Maine is a gem of a town, it is straight out of a story book. The residents and I got along great and I felt I would be pretty happy here. Another tough place to rank given so many pros. Biggest con was distance from family, which would have been hard. If it was just me I would have possibly ranked this place closer to number 1, it was just that good.

6) VA -- Eastern Virginia Medical School
Another great program, good focus on ultrasound. Residents were okay, not my favorite but definitely not the worst. I thought Norfolk was badass personally, it was like a San Diego-lite. I felt my view was a little muddled because it was unseasonably warm. Biggest con would be the EM department head was kind of an old boys club sort of guy, definitely wouldn't love to work with or for him. Otherwise a solidly average place I wouldn't mind matching at.

7) TX -- TX A&M Scott & White Memorial Hospital
The training here seems really good. The town really sucks, even though it's an hour away from Austin. Also working that many 12s as an intern sounds utterly miserable. Otherwise the cost of living in low. Residents were alright, it was a little too Texas suburbia for me, where daddy goes to work and mommy stays home with the kids and organizes activities. Not that that is necessarily bad, just wasn't the sort of culture myself and my wife really vibed with.

8) NC -- East Carolina University/Vidant Medical Center
Not a terrible place, the ER was hopping during our tour. Faculty seemed pretty chill, with the exception of the PD who was a little odd. Probably my least favorite residents I interacted with on the interview trail. What ultimately made this place last was poor fit and distance to family. Otherwise it's alright.
 
Applicant Summary
Board scores: 220s/250s
EM rotation grades: High Pass/Honors
AOA: No
Medical school region: Northeast
Anything that made you more competitive: Not a single thing

Main considerations in creating this ROL: Originally from the southeast area and wanted to return there, but was ok with other locations if they had mountains and were near the east coast. With that said, I really want out of the giant city; I'd prefer a smaller-medium sized city. I'm not into research/academics at all really, so I wasn't looking for ivory tower programs. 3>4 but not a deal breaker if I liked the program and it had a good use of that extra year. Everyone talks about fit, but it really was a huge factor after location-I just didn't want to spend another 3-4 years at a place where I didn't feel like I belong.

1) VA -- Virginia Commonwealth University:
I really couldn't find anything I didn't like about this program. Was super comfortable at the dinner the night before and all the residents made me feel welcome. PD was absolutely amazing and one of the most genuine I met on the trail-seems like a really supportive guy who's really passionate about the program and his residents' well being. All of the faculty I interviewed with were really happy people who were just interested in getting to know me and my story without grilling me at all.

Pros:
-The new ED is gorgeous and has a massive new trauma bay with a whole bunch of toys. Oh and there's a chick fil a in the hospital
-No floor months
-Lots of ICU time
-Close to family
-10 hour shifts. Seems like the sweet spot
-Can moonlight and get attending rate the last 6 months (I have a lot of debt)

Cons:
-Comparatively, apparently their benefits aren't as great

2) VA -- Eastern Virginia Medical School
Rotated here and really enjoyed it. The residents were all really cool and really normal down to earth people, super humble. I like the more community feel but that it still was academic ish with the tertiary care hospital as the main site (rotate at a suburban ED and a rural ED as well). The PD again was a super nice guy and genuinely cares about his residents and the program.

Pros:
-Free standing Children's hospital/ED, so good exposure to stuff like peds anesthesia and peds sedation in addition to normal peds ED
-8/9's
-Close to family and by the beach
-Good COL
-Seems like the ED residents are well respected by the other residency programs (shouldn't matter but it's a nice bonus)

Cons:
-ED was under renovation and a bit of a mess, but hopefully will be finished soonish
-Outside of trauma month, the residents don't seem as involved as compared to other programs.
-Not a massive city, so not a bunch of trauma, but is by the naval ship yard so you see some unique stuff

3) VA -- Carilion Clinic - Virginia Tech Carilion Emergency Medicine Residency
Location is absolutely beautiful with mountains everywhere-great for hiking, biking, fishing, etc. The hospital system has apparently been around for over 100 years, but in the last 7 or so, it's gotten a major overhaul so all the buildings are brand new (including the new med school).

Pros:
-Crazy low COL
-Huge catchment area makes up for the relatively remote location
-Brand new massive SIM center is amazing and apparently utilized pretty frequently compared to other programs
-Full responsibility immediately-you're seeing all levels of patients and working 1:1 with an attending each shift
-Program where you are paired with a nurse from the beginning and she's your go to throughout residency for all things nursing. Kinda cool and seems like it improves the relationship among the staff
-The PD seems like the guy you either love or hate, after reading all the comments on the spreadsheet this year. I thought he was a little full of himself, but a cool, really intelligent guy nonetheless and all the residents had nothing but good things to say

Cons:
-There seems to be a bit more emphasis on research than I would've liked (but most of the residents said they weren't really interested either and it wasn't a problem)

4) PA -- Penn State Health Milton S Hershey
I didn't think I'd enjoy my time here as much as I thought, but the people bumped it up. Normal residents who weren't full of themselves and just really open to talking to all the applicants. For sure not the strongest or most well known program for EM, but at the end of the day I think most residencies will get you to the necessary level you need to be at to practice.

Pros:
-Massive hospital with every specialty you could want, which is surprising given the location.
-Not a whole lot of trauma, but still lots of medically complex patients from huge catchment area
-Expanding the ED and PICU, as well as a brand new peds ED
-Mountains

Cons:
-Hershey/Harrisburg really didn't have much going on, even compared to VT in Roanoke.
-Apparently have a difficult time getting procedures from ortho

5) NC -- Wake Forest University
Obviously a strong, older program (#2 actually as the PD pointed out repeatedly). Honestly, this program wouldn't be as high as it is if not for reputation and it being a location I'd like to practice on day. Other than that, I didn't really care for the PD, he seemed very cold and relied heavily on the name (came across as one of those "if you don't like it, here's the door, I have plenty of other interested applicants"). Had another really poor interview experience with a guy who was just gruff/noninterested and read 5 or so questions off a sheet and wrote down my answers. Then ended the interview-whole interview was 4 minutes. Residents seemed super smart and normal-didn't love or hate them.

Pros:
-Most number of ED months out of all the programs I applied to (including 4 year programs)
-Lots of ICU time
-Strong reputation-well regarded by rest of hospital
-Low COL (but also a really boring city)
-8's

Cons:
-Leadership and I just didn't click.
-WS is pretty sleepy

6) CT -- University of Connecticut
Residents and leadership-didn't give off the ivory tower vibe and were just really unintimidating friendly people. They made me feel special important (LOLLLLL). This is what really made me put it this high. Outside of that, it was a pretty standard program, if not even a little bit on the weaker side.

Cons:
-Really didn't like Hartford
-18 8's per block-this just really doesn't seem like enough time to learn EM in three years

7) PA -- Hospital of University of Pennsylvania
If this program were in a smaller city or closer to outdoorsy crap, I'd have put it a lot higher. The PD was really cool and obviously whip smart. The residents all really seemed to like hanging out with each other, and they have the best resident lounge out of all the places I interviewed. It's Penn so they have a ton of money for cool stuff. This place really seemed like a really normal/basic EM program with a **** ton of little "extras"

Pros:
-CHOP and all the rotations that go with it. Enough said
-Building a new ED across the street
-Residents were cool
-Philly PD will "scoop and deliver" totally undifferentiated traumas to the ED without any interventions started

Cons:
-2 years of 12's, with residents saying they frequently stayed 2 hours after end of shift
-Huge city.
-It's UPenn, so the ED is crapped on by all of the ivory tower consult services
-Too academic for my taste

9) NY -- University of Rochester
Probably the biggest negative surprise I had on the interview trail. I really thought I'd like it here due to the cooler weather and mountains/location. Dinner the night before was at a resident's house, so it was nice to see how you could live on the salary in the area. Got a fratty/semi-broey vibe from the residents at the dinner, and a mildly douchey vibe from them at the interview day. Not to say they were all like that, but enough for me to notice and not feel like I fit in. What really did it for me though was the PD-he blew through his presentation and then through my interview like he couldn't be bothered. Out of all the PD's I met, I liked him the least. Super bummed because otherwise it seemed like a decent program in a cool area.

Pros:
-area

Cons:
-ED itself was meh. Cluttered and work areas falling apart (and elevated a couple of steps and carpeted?)
-Fratty residents
-PD
-No integrated peds curriculum (4 months separate)

10) NC -- East Carolina University/Vidant Medical Center
I'm all for smaller cities/towns but man. This place is in the absolute middle of nowhere. Resident I talked to was literally excited about the second Walmart being built in town. No mountains. No city life. Literally nothing to do. Residents really put the nail in the coffin for me though. They weren't mean or awkward or anything, just... despondent? dejected? They had absolutely nothing positive to say about the program, just that they picked it because it was in an area the needed to be in. Even when I asked about some highlights/something positive they liked about it, they couldn't come up with anything. Also, PD is a super weird guy to a really uncomfortable level. 10/10 cringe

Pros:
-no ortho residency, so you get all fractures
-wide catchment area
-sweet tea during interview lunch was on point

Cons:
-see above

11) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
Ultra county. Didn't click with attendings (any of them). Residents were all pretty cool and seemed to like their program, but did admit that the 12's in a 4 year program were rough, and that the ancillary support staff was.. ahem.. lacking. They do a lot of their own IV's, wheel pt's to imaging, etc. They do get tons of trauma though. The reputation speaks for itself, they all come out badasses, but it's just not the environment I see myself practicing.

Cons:
-I hate big cities
-I REALLY hate the Bronx

Anything else to add? I feel like your first choice and bottom few choices are the easiest to rank because your reactions to them are so strong. I made this list about a month before it was time to submit and felt good about it. But as I got closer to the deadline, I felt myself questioning it a bit. It's good to have a little bit of hesitation, but for the most part trust your gut. The hardest part is deciding what's right for you. It's helpful to look at these lists to see what people think of them, but at the end of the day it's you spending 3-4 years of your life around these people and in a potentially new city. Don't pick a place just because everyone else raves about how "they work you into the ground but you come out amazing" and "legendary reputation". If something about a place bugs you or you don't click with it, it's cool. Do you.

Interviewed: All of the above
Declined: none
Rejected: Maryland, Carolinas, SUNY upstate (lol), 10 or so others. The rest ghosted.
 
Applicant summary
Board scores: 230s/250s
EM rotation grades: High Pass/Pass
AOA: No
Medical school region: Oklahoma
Anything that made you more competitive: no,

Main considerations in creating this ROL: couples match location

1) FL -- University of South Florida
My wife's number one. Good program. Good leadership.
2) AZ -- University of Arizona
3) FL -- Aventura Hospital & Medical Center
4) FL -- Oak Hill
Was not excited to rank it this high but it gave my wife a second shot at her number 1 program. interview day was meh.
5) MO -- University of Missouri Columbia School of Medicine
6) NE -- University of Nebraska Medical Center
7) FL -- Aventura Hospital & Medical Center wife had two interviews in Ft. Lauderdale
8) VA -- Eastern Virginia Medical School
9) OK -- University of Oklahoma College of Medicine/Tulsa
10) FL -- University of Central Florida/HCA GME Consortium of Greater Orlando
11) MS -- University of Mississippi
12) AR -- University of Arkansas
13) NJ -- Hackensack University Medical Center
14) MO -- St Louis University School of Medicine
15) LA -- Louisiana State University - Baton Rouge
16) IL -- Southern Illinois University
17) LA -- Louisiana State University - Shreveport

Declined: University of Florida - Jacksonville, Kendall regional medical center, Western Michigan University

Note from @TrashPanda13: Not completely sure why Aventura was listed twice. Don't really understand the explanation, but didn't want to change anything.
 
Applicant summary
Board scores: 210s/250s
EM rotation grades: Honors/Honors/High Pass
AOA: No
Medical school region: Northeast
Anything that made you more competitive: Had a couple of leadership positions, above average third year grades, top 30 med school(if that’s important idfk), I think my SLOEs were top 1/3, middle 1/3, middle 1/3 from what I read upside down across the table in really ****ty hand writing(still unsure). Got one or two comments saying they said nice things about me in my SLOEs. Everyone really seemed to like my personal statement. I think I am normal.

Main considerations in creating this ROL: Gut feeling, LOCATION, tried not to look too hard into 3 vs 4 year programs but I secretly prefer 3, tried to keep perceived prestige out of my decision making process but im sure theres some subconscious influence. Part of me thinks I want to do academics, but I also realize that soo many of us think we want to do academics when in reality we won’t.

1) TX -- UT Southwestern Medical Center - Dallas
I was at the pre interview dinner with the margarita machine and it was fantastic. The residents were cool seemed to be quite happy. On interview day, most of the interviews went smoothly-There was one with a lot of behavioral questions and then the PD interview was super brief and it was a lil weird but she was also post overnight. In terms of the program itself I liked that they rotate a good amount at Dallas Children’s ED and in their third year they spend a lot of time at different community sites to really get a flavor of how EM is practiced in different settings. They also kind of split their adult ED time between Parkland and Clements with Clements being the university hospital with strange pathology and parkland having a more county feel. I also stayed a couple of days after in dallas and really liked the city-its pretty cheap relative to where I am coming from, a lot of young people and **** to do in free time. **** winter.

Cons: 1) trauma surgery is king here and 2) felt like there was a lot of consulting. At parkland they literally have a separate OBGYN ED basically which was ****ing weird. Clear to me there this wasn’t a place where you finish all of your procedure requirements after intern year, but honestly I don’t know how important that is at the end of the day.

2) TX -- University of Texas Houston
Rotated here, and coming from a four year program I was really impressed to see what the PGY 2 and 3s were capable of here. I got the sense that they work hard but the faculty all seemed damn supportive and they all seemed like a close knit group of people. Good Peds exposure through their main hospital and texas childrens, they also get a super county experience at LBJ and more of a tertiary care feel at Memorial Hermann. I especially liked that there were a good chunk of younger residents here even though that’s probably coincidence. Also have a lot of young faculty doing cool things ie deputy editor of wikiem. Houston has plenty to do and yeah its humid but it wasn’t intolerable. Also, **** winter. Honestly this and Southwestern flipped flopped a lot in my mind for number 1

Cons: sounds like they have had problems with trauma surgery in past but no longer, residents’ main complaint was ortho is weak but again I don’t know how much that’s really gonna affect my training.

3) MA -- Boston Medical Center
Great group of residents and faculty and it would probably be my number 1 if it were in a warmer city. EM does pretty much everything in trauma situations and the ED here is just…wild. This is honestly a fan ****ingtastic program and anyone who ends up matching here will be really happy like the faculty and coresidents really care about each other. I’m really just not as big of a fan of boston for winter reasons.

4) ME -- Maine Medical Center
I reallllyyy like what this program has to offer. Its tertiary care level stuff without the competition of services like ortho, optho, ent. The residents were all nice and very happy with their choice. For those interested in academics, they match their residents into very competitive fellowships. Portland maine is a small city but its really cool-incredible food and beer. Faculty all seemed really nice and interviews were mainly conversational, they all warned us the PD is a really nice normal dude but comes off weird in the interview. This was true.

Cons- winter. Portland maine is a great city for beer and food and outdoorsy stuff. I don’t think it’s a great place to be 25 and single. The residents were pretty much all in very commited long term relationships/married with kids. There’s absolutely nothing wrong with that, I just feel like we might have different interests of what to do in our free time. Looking at their alumni list a lot were in the northeast and I think I want to go back to socal. Winter also sucks. Despite this, the people and the cool clinical opportunities this program has to offer made this program high on my list.

5) MD -- Johns Hopkins Hospital
They actually have a real reason for having a fourth year. Residents were normal people for sure and the program director seemed like a really nice person. The residents here didn’t really feel like they were overshadowed by other services and really said the residents on other services were keen on teaching ED residents. Lots of fellowships which I feel helps with teaching. Interviews were by in large normal, one person was kind of on the spectrum but hey its luck of the draw.

Cons-Baltimore isn’t the best city but it could be worse I suppose. They had a mandatory QI project every year(residents said was no big deal) and their emphasis really is on making academicians. Again, im probably going to end up in the community just like everyone else, and they still send around 60% of their grads into the community so im sure itll be fine.

6) CA -- Riverside Community Hospital / University of California Riverside
Program director here, as everyone else has mentioned ,seems like the real deal on wellness… like he used to be a clinical psychologist prior to going to med school. While it is a newer program they have a lot of the old loma linda faculty and I feel like they know what they are doing. Great procedure volume, despite being a level 2 they see a lot of tertiary care level stuff and both penetrating and blunt trauma. Free food from cafeteria(not playing a role in my decision but hey it doesn’t hurt). mommy and daddy live 30 mins from here and im sure this place would be great for finding a job in socal.

Cons-newer program. HCA association (which I think people need to calm the **** down over) but it really didn’t seem like they had a move the meat mentality. They seemed to be more focused on training physicians for the community but there still seemed to be academic opportunities available. The biggest con for me was riverside itself-kind of the armpit of Socal and the city kind of depresses me. You can still get to the beach, mountains or desert in an hour but yeah riverside blows.

7) MA -- University of Massachusetts
Well established program and they know what they are doing. Residents were all pretty nice at the interview dinner. I actually really enjoyed most of my interviews especially with the APD. There was one lady who was kind of off putting but she was post night shift and you cant let one odd duck sway your entire decision. Program director is a good dude-also heard the story about how someone was going through personal **** and the PD literally worked his shifts. I think this is a solid program that is well established with good opportunities for any sort of interest.

Cons-Worcester. Worcester sucks and that’s the main reason why this is lower. The residents seemed like they worked hard but they didn’t seem like they were suffocating from the workload.

8) MA -- Baystate Medical Center
Program director seemed like a really really good dude. Came out to the interview dinenr but kept just enough distance from the applicants. They look like they have really solid training and don’t have competition from optho ent ortho. A lot of newer in hosue fellowships which is nice from an educational perspective. Residents were all funny and fun to be around and were definitely happy. They all really loved the program leadership an They seemed to place residents all over the nation so I think I could find my way back to California after being a resident here. While not a pro for me- they are super family friendly.

Cons-location. If you translocated these people to a different location it would be quite high on my list. Im sure some people would find this location to be a pro in terms of outdoors access.

9) NY -- New York Methodist Hospital
Residents at the dinner were cool seemed like they ahd fun outside of work but I will say it felt like they were a little overworked. Interview day was fine and the interviews were pretty solid and residents were able to get solid fellowships. They placed a big emphasis on the strength of their ultrasound program. Park slope is a really cool area and NYC is an incredible place to be young. My one qualm with this program is the trauma-they rotate for trauma stuff at brookdale which now has its own EM residency and there was mumblings of the situation staying the same for now but that it might change. Also thought it was weird how they were bragging about how their sim guy is great with low fidelity sim…like a beautiful sim center isn’t going to make or break an educational experience but if you have ****ty sim don’t brag about it

10) TX -- Texas Tech Health Science Center/Paul L Foster School of Medicine
Rotated here and really liked most of the faculty and residents. Weird pathology and interesting patient population who are coming from Juarez with absolute dog**** medical care. Not too much competition from off service. Two reasons why this isn’t ranked any higher. Lot of inbreeding amongst faculty and on some of the shifts I felt like there were some attendings who weren’t exactly using evidence based medicine. Also do not like el paso. However I know they have a lot of alumni working in socal so good job network I suppose.


11) GA -- Wellstar Kennerstone
new program residents were cool, locaton’s not bad considering pretty damn close to Atlanta. They were transparent about not having a lot of penetrating trauma(again im not sure how huge of deal this is) but they were definitely getting a lot of blunt and this was definitely a good place for procedures. The program director used to be an APD at Emory and was there for a long time and he seemed like he knew what he was doing. That being said I kind of had a negative interview with the program director. FL -- Florida Atlantic University Florida Atlantic- definitely least workload 15, 12 hour shifts a month. Faculty all seemed like nice people and I actually really liked talking to the program director. Hard to explain why im ranking this lower than other new programs on my list but I just didn’t feel like they had the pathology, volume, or their general **** as together as other places. nice people and great location though.

12) PA -- Albert Einstein Medical Center
Program has been around for a while but this was the place I felt like the residents were just plain overworked. Multiple times throught the day residents seemed to think they really work a lot, they were all super nice though. On the tour even a resident from another service thought they worked a lot. They have a ****ton of ICU time in their curriculum. I hated philly idk why I just really did. The hospital is a real county hospital and seemed run down on the outside but that didn’t play too much into my decision making. I will say that I stayed after to observe in the ED and it seemed like my kind of patient population.

Anything else to add? applied pretty broadly to 89 programs, because of a weak step 1 score and I interviewed at every place I was offered. I will echo that its impossible to tell which programs will interview you if you have something like a weak step 1 score and(apparently) ok but not great sloes. Id be happy if I ended up in my top 6, medium happy from 7-9, and after that I’d be a little upset. To people who are third years with weak step 1 scores applying into EM-this sheet should tell you that step 2 can make up for a weak step 1 and SLOEs are the most important thing. You don’t have to go to some big name program-if you can find a place that you know doesnt bone its rotators with ****ty SLOEs. I know I wrote a lot but I remember lurking on last year’s ROL a lot so maybe thoughts will help someone.

Declined: none
Withdrew: none
Rejected: muchos
 
Applicant Summary
Board scores: 210s/240s
EM rotation grades: High Pass/High Pass/Honors/High Pass
AOA: No
Medical school region: Midwest

Main considerations in creating this ROL: Geography

1) MN -- HealthPartners Institute/Regions Hospital
2) MN -- Hennepin County Medical Center
3) MN -- Mayo Clinic School of Graduate Medical Education
4) IA -- University of Iowa Hospital & Clinics
5) OH -- Mercy St. Vincent Medical Center
6) IL -- University of Illinois College of Medicine/St. Francis Medical Center at Peoria
7) MI -- St John Hospital & Medical Center
8) PA -- Allegheny General Hospital
9) IL -- Southern Illinois University
10) OK -- University of Oklahoma College of Medicine/Tulsa
11) MO -- University of Missouri Columbia School of Medicine
 
Applicant Summary
Board scores: 230s/240s
EM rotation grades: Honors/Honors/Honors
AOA: No
Anything that made you more competitive: Top 10 school, I think I had top 1/3 SLOEs (read it across an interviewer's desk), former EMT, a lot of research, top 25% MSPE

Main considerations in creating this ROL
High: gut feeling/fit, location (east > west coast), ability to work with medically underserved populations
Medium: 3 > 4 year, research opportunities, prestige/reputation
Don't care about: shift length, off-service

Will likely go into academic EM

1) DC -- Georgetown University Hospital/Washington Hospital Center
Real tossup between #1 and 2 ranks. Eventually I decided to choose a place I rotated at, knew I would enjoy the program and people, and become a strong ER doc at. I am sure that would happen at my #2 rank also, but it was reassuring to have a test drive at my #1 program.

Pros: Rotated here and loved it. Got along very well with the residents and attendings. Thought that didactics were fun and everyone was great to work with clinically. Unique in the 1:1 resident to attending ratio throughout residency. DC is my #1 city. I like the two different main sites with the academic at GUH and the primary site at WHC, which was county-esque but with the financial backing of the MedStar health system. I thought this resulted in better care for patients who would otherwise be seen in a true county hospital (my medical school has a well-known county hospital and a lot of stuff falls through the cracks with understaffing and general underfunding).

Cons: less prestigious/well known in EM than other places I interviewed at

2) MA -- Harvard Affiliated Emergency Medicine Residency at Beth Israel Deaconess
Pros: Strong academically (~Harvard~) and large diversity in clinical sites so you see a wide range of patients. Really like 3+1 model with junior attending year (why don't more places do this??). Academic and research strengths of this program aligned with my own. Sushi dinner/journal club was so good and the residents I met there seemed to be having an awesome time.

Cons: Got the vibe that the patients that were seen at BIDMC and associated hospitals were mostly white/upper middle class. The medically underserved in boston tend to go to BMC. Low trauma volume.

3) MD -- Johns Hopkins Hospital
Pros: Chair's rounds were hilarious and my chair interview was one of my favorites of the season. I felt that this was a very fun and tight knit residency class. A lot of unique and rare pathology due to it being Hopkins. Big name in medicine generally. Research interests here also align strongly with my own.

Cons: Possibly overshadowed by Maryland/STC. Other services at Hopkins are very strong.

4) NY -- NYU/Bellevue Medical Center
Pros: Awesome diversity in clinical training sites (Bellevue, Tisch, Brooklyn - which makes up for low trauma volume which was a prior weakness). Famous faculty, especially in tox. Love the social mission of Bellevue. Morning conference every AM is a positive for me.

Cons: I've lived in NYC before, not sure if I want to do it again

5) MD -- University of Maryland
Pros: Badass PD, wants to make future leaders in EM. Shock trauma experience sounds incredible and I was so impressed by the trauma intake area. Strong alum network with many national leaders in EM. EM is relatively a very strong service in the hospital. Extremely strong clinical program.

Cons: Residents seemed kind of tired, but it was also one of my last interviews so idk.

6) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pros: Super badass and famous name in EM. Really like the idea of teaching before/after shifts. EM runs the show in this hospital which is super county, but the faculty also crank out a lot of high profile research. Big into the social mission of EM.

Cons: Didn't mesh super well with the residents here. I don't really speak Spanish and I think they said over 60% of the patients are Spanish speaking only.

7) PA -- Hospital of University of Pennsylvania
Pros: Very academic, extremely tight knit residents that were kind of bro-ey (but that is kind of me so...). Strong community rotations. EM seems strong within the hospital despite Penn being an academic powerhouse for most services. Seems to take most of the west philly trauma.

Cons: unsure of the utility of the 4th year

8) PA -- Temple University School of Medicine
Flipped between Penn and Temple for the #7 spot a lot.

Pros: I think either here or Maryland was the strongest in trauma education that I interviewed at. Lots of North Philly trauma. Very strong clinical program. I got along with the residents really well here and they seemed pretty happy and chill!

Cons: Didn't love North Philly (telling that almost no one lives around the hospital). Hospital system seemed a little less well funded than others. Strange interview with chair who kept steering the conversation towards dragon boat racing (??)

9) CT -- Yale New Haven Medical Center
Pros: Extremely strong academic program with a huge catchment area so they get lots of local stuff and they also get a lot of rare things that are flown into Yale. Bridgeport seems like a good community rotation.

Cons: Don't really want to live in New Haven for four years

10) VA -- University of Virginia Health System
Pros: Strong academic program. Really liked the PD who has been at UVA since medical school. New ED opening next year. Charlottesville is an awesome town. Research interests align with my own.

Cons: lower volume ED, would prefer to be in a large city

11) DC -- George Washington University
Pros: DC is preferred city. I really liked the PD Colleen Roche. I don't particularly have an interest in public policy but that is a strength of this program.

Cons: a lot of rotations in northern VA, seems like most of the residents didn't actually live in DC. Not a lot of resident turnout at the dinner.

12) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: Sarah Williams was probably my favorite PD of the trail - total badass. Stanford has like unlimited funding and is a huge name in and out of medicine. Seems to be very committed to resident education.

Cons: Palo Alto is like big city prices but without any of the features of a big city. Wish they had more county time.

13) NY -- Mount Sinai School of Medicine - New York
Pros: One of my favorite resident dinners. I think this was the most close-knit group of residents I met on the trail, which is crazy because there are so many of them! I really liked the PD (Shah) but he's leaving this year. Seems like the most down to earth of the New York programs

Cons: I felt like everything Sinai has (academic: Sinai, county: Elmhurst, community: Beth Israel), NYU had (Tisch, Bellevue, NYU Brooklyn) but better and with less commuting.

14) VA - Virginia Commonwealth University/VCU
Pros: Richmond is a cool city. Impressed with the trauma resources here. Probably the strongest clinical training of the Virginia programs. Liked Dr. Moll a lot - he seems pretty committed to diversity and inclusion in the program and recognized it was a prior weakness but is actively trying to improve. Also seemed like he cared the most about his residents of any PD I met.

Cons: Felt like the graduates didn't land strong academic jobs based on speaking with the faculty. Probably the most awkward interactions at resident dinner of my interviews

15) VA -- Eastern Virginia Medical School
Pros: I had so much fun at this resident dinner. We were at someone's house and basically grilling and drinking around a bonfire. Impressed by the hospital system as a whole.

Cons: don't really want to live in Norfolk, felt like the grads didn't land the strongest academic jobs. EVMS relatively low reputation in medicine compared to other programs I interviewed at.

Anything else to add? I honestly enjoyed everywhere I interviewed at and think I would be a successful and happy resident at all of them. Declined: Medical University of South Carolina, Brown University, Dartmouth-Hitchcock, Albert Einstein/Jacobi, Jefferson University, Maimonides Medical Center, Lincoln Hospital Center, University of North Carolina
Withdrew: Vanderbilt (high-priority waitlist)
Rejected: Duke University, Mass Gen/Brigham/Harvard, Boston Medical Center, SUNY Downstate/Kings County, St Luke's Roosevelt - Sinai, Virginia Tech Carilion, Carolinas Medical Program, USC/LAC, Emory, NY Pres/Cornell/Columbia
 
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