Posted anonymously via
Google Form.
Applicant Summary:
Board Scores: 260’s/260’s
EM Rotations: Honors/Honors
AOA: No
Med School Region: East coast
Anything else that made you more competitive: Unique background
Main considerations in making this ROL:
-Clinical Training
-Location: job opportunities and social life for spouse, want to be near home
-Fit: Do I like the R1s and R2s?
-County = Community < Academic (#1 and #3 both super academic but are close to home; however, #1 has a good mix of academic/county/community).
-#4-#9 are all spectacular in terms of clinical training, and I would be happy at any of those programs.
1) WA- University of Washington Program (Seattle)
a. Pros:
- Close to home, great job prospects for wifey, no more missing family/friend functions. Huge catchment area. Good mix of Community/PEDS/County/Academic with super complex pt population. Amazing outdoors. Loved the residents. 4 months of career development pathway electives. Oh yeah, PD is a total rockstar who will fight to the death for her residents, one of the most passionate PDs I've encountered. I think those who spoke poorly of PD were butthurt that she didn't buy into the bull**** they were feeding here during the IV #dontbefakebro. Residents say they get an above average amount of procedures but not crazy high. Overall, you will become a well-rounded BALLER. 10 hr shifts (a few 12s during certain intern rotations). Huge push for social advocacy, which to me is super cool, but not everyone's cup of tea. PNW is kickass.
b. Cons: Super academic. Newish program with the usual **** that tags along with it. Some graduated responsibility but not etched in stone like some programs. For instance, interns get some procedures but not many. Per a resident during IV day, R1 is “learn to be a doctor”. R2 is “learn to be an EM doctor” via procedures, see sick pts, critical care management, get R4 supervision, run resuscitations but get kicked off if you suck. R3 is “become a teacher, manage multiple critically ill pts, no more training wheels”, minimal R4 supervision. R4 is “supervisory role/educator, polish your skills mode. Intern year blows, but at least I’m supported by family and friends and get to see my dog. 4 years. RAIN, RAIN, RAIN, RAIN, yep....more RAIN. COL is getting out-of-control with lack of housing and the tech business influx. Will be poor for 4 DAMN YEARS.
2) MI- Detroit Medical Center/Wayne State University (Sinai Grace)
a. Pros: One word....BALLER. Clinical BEAST-MODE baby! Holy ****, 3 yrs of pure bliss in the medical arena. If you want to be a cowboy this is it, if you want that safety net then you got that option too. Also managing the sickest of the sickest pts. EM gets it done in the hospital. High acuity, volume, tons of procedures, significant trauma, autonomy to the max. interns get first shot at procedures. New ED. 8 hr shifts. Family in Detroit. EM runs traumas and gets all procedures...take a seat Surgery residents
b. Cons: Far from home. Detroit ""is having a rebirth"" but it's still Detroit....cold AF winters and Gotham vibes. If this were closer to home or if I were single it would be #1 hands down. State and city income taxes blow with a relatively low salary to begin with. Limited hospital resources is an issue and sucks to be conscientious of on a daily basis for 3 years. Relatively low salary for having state and city income tax as well as federal tax. No-nicotine policy won’t be a problem but seems inane (no occasional cigar).
3) CA- Stanford
a. Pros: numerous resources to help you find your niche, will push you to become a leader in EM, brilliant residents from other specialties to learn from, brand new ED, set you up for academic job afterward (not sure that’s what I want but nice to have the option), autonomy seems fine, west coast, Yosemite NP 4 hours away, 10 hr shifts!!! No more 12s baby. “Admitting privileges” per resident. Housing stipend.
b. Cons: the whole ""healthy/insured palo alto population""...., possibly low procedures, 4 years, Surgery runs trauma pts but EM gets airway, high COL, traffic, low county time (sounds like this won’t change in near future). Overall, would get solid training but not enough exposure to hardcore cases/”**** hits the fan” moments; but, is semi-close to home and can get a job anywhere afterward.
4) CA- Riverside
a. Pros: SoCal. Community Hospital (PD says it functions as a county hospital with tons of resources), Awesome PD, lots of procedures, wellness, west coast, EM runs traumas (Surgery residents stay away from ED for the most part), PD emphasizes seeing lots of pts, relatively low COL for California, could boost my golf game given nice weather all year, no more freezing my ass off during the winters and getting a rusty car from absurd amounts of road salt....that **** gets old fast
b. Cons: job opportunities for wife? Reputation outside of Cali? one site for 3 years. New program so networking issues once done but PD discussed his HCA program hook-ups after graduating.
5) MI- Henry Ford Hospital/Wayne State University (Detroit)
a. Pros: Well-established and respected program. High volume, high acuity, very very sick pts (virtually everyone with renal failure, heart failure/LVADs), EM runs trauma resuscitations, great critical care, overall excellent clinical training, tons of procedures (central lines, a-lines, intubations). 3 elective months! 4 vacation months! Very similar to Advocate Christ in terms of acuity/volume/procedures and # of elective months. Interviewers are happy with caliber of their resident graduates. Subsidized housing in close proximity to hospital
b. Cons: Despite EM residents running the trauma resuscitations, Surgery shares the ""big boy"" procedures (residents mention surgery senior sometimes allows EM residents to do chest tubes like wtf man)....I know this is quite common and can seem petty but it's annoying when ""EM runs traumas"" yet dealing with surgery for procedures, graduated responsibility (interns do basic procedures and see bread & butter EM cases, PGY-2 gets first opportunity for procedures and sees higher acuity pts, PGY-3 runs resuscitations and also does procedures as needed. Excessive income taxes (federal, state, and local). Ortho does reductions. No nicotine policy (blood or urine tests haha), again not a issue for me but seems authoritarian to the max.
6) IL- Advocate Health Care (Oak Lawn, Chicago)
a. Pros: Training for EM near South Chicago which has one the highest homicide rates in the nation? Damn right. Very high volume, high acuity/tons of trauma, lots of procedures, lots of U/S fellowship-trained faculty, emphasis on wellness, very cohesive faculty/resident dynamic (first name basis with attendings), no graduated responsibility, hit the ground running on day 1 is awesome...I hate hand holding, EM runs Level 3 traumas, job opportunities for wifey
b. Cons: not all procedures (interviewer said ENT attending does PTA drainage, again I know it sounds petty but if I'm doing residency far AF from home I at least want to become proficient at all reasonable procedures), brutal winter, commute from Chicago or forced to live in ****ty Oak lawn, Surgery runs Level 1 and 2 traumas but EM gets airway. All the residents with whom I interacted seem like total urbanites so not much diversity in terms of upbringing. Dinky adult ED is crammed with incalculable hallway beds (don’t want to deal with that nonsense for 3 years); however, ED is “getting renovated” in near future so probably after I finish residency lol
7) TX- University of Texas Health Science Center at Houston Program
a. Pros: One of the best if not thee best county/academic/community/PEDS mix of training sites in the country. Great PEDS exposure (TCH has super complex kiddos). Busiest Level 1 Trauma Center in the country. Brand new massive trauma floor. Job opportunities for wifey
b. Cons: Trauma 1: EM gets airway and Surgery does everything else; however, EM runs Level 2 and 3 traumas. Unable to tolerate super hot/humid summer. Unnecessary stress of worrying about that hurricane threat. Aside from nice urban parks the outdoor activities are limited. Massive class size (20) seems impersonal
8) TN- University of Tennessee College of Medicine at Memphis Program
a. Pros: PD is a bulldog (will go to war for his residents), faculty very dedicated to program improvement, TONS of procedures just like CHRISTUS (but not doing thoracotomies like you would at CHRISTUS), very sick population just like Detroit (tons of strokes, MIs, renal failure), new ED, hit the ground running (PD emphasizes interns seeing the sickest pts on Day 1), low COL, amazing BBQ, tons of outdoor activities nearby, small resident class size (6), large catchment area. Residents are genuine and my type.
b. Cons: new program so turf battle dispute (getting better per PD), trauma goes to Regional One center so when at Methodist Hospital (main site) you see minimal trauma, job opportunities for wifey, Reputation outside of TN? Humid summer. Super far from home (I'm tired of routinely missing family and friend functions for the past 4 years).
9)TX- Christus Health/Texas A&M College of Medicine/Spohn Hospital Program
a. Pros: functions as unopposed residency (only FM which stays away) so EM residents get ALL the procedures, work alongside trauma surgeon attending (no surgery residents), ridiculous amounts of procedures including getting the rare ones, residents spoke about how sick the pts are (ex: pts presenting with HR 30s from hyperkalemic heart block are not uncommon), lots of trauma (Level 2 trauma center), brand new ED, will be very comfortable starting as attending, good PEDS experience. Loved the down-to-earth, humble residents yet could handle virtually any medical emergency...that speaks a lot to me as opposed to some some loud, pretentious losers I met at other programs.
b. Cons: job opportunities for wifey seem scarce. Grimy “beach” town. While I would enjoy the outdoors there, I’m not sure she would. If I were a single dude then this would be a contender for my top 3 programs
10) UT- University of Utah Program
a. Pros: Super cool PD. Beautiful location. Both the academic and community facilities are new. Close to home. Wifey likes area. I loved the faculty at academic site. Didactics were engaging. Residents seem cool.
b. Cons: Surgery runs traumas, sometimes anesthesia gets involved. Low # of procedures. Low acuity. Overall, would come out of here as a good clinician but just not enough exposure to super sick pts like you see in Detroit, Corpus Christi, Memphis, Oak Lawn, etc
11) WI- University of Wisconsin Hospitals and Clinics Program (Madison)
a. Pros: 3+1 structure is genius, faculty are very committed to resident development/career ambitions, program has $$, badass flight program (Wisconsin requires flight physician to ride aboard helicopters so tons of opportunities for riding along and can be the solo flight physician during R3 if you feel like being Cowboy Rambo), nice facility, random pathology such as farming accidents. Overall, solid program just far from home and cold AF winters.
b. Cons: procedures? Low acuity? Not super sick population. Long, cold freeze-your-nuts-off winters…even the Uber driver said winters are absolutely brutal here. Wifey hates the cold and there are no mountains to ski despite tons of snow.
12) NY- SUNY Upstate (Syracuse)
a. Pros: moderate amount of trauma, large catchment area, diverse population with high refugee percentage, PD is a baller, 8hr shifts, strong PEDS.
b. Cons: Surgery runs traumas and gets most procedures (EM gets airway but that’s about it) like most academic programs so also consult-heavy system, Suboptimal winters. Very far away from home. Super low salary ($50k R1 not to mention NY income tax). Outdated and crammed ED. Overall, good training but not a fan of living in Syracuse for the next 3 years with a low salary and few procedures.
13)PA- Penn State Milton S Hershey Medical Center Program
a. Pros: Large catchment area with complex pt population (LVADs galore, genetic conditions, Amish) since it is the only Pediatric and Adult Level 1 Trauma Center in the state. Strong EMS experience. PD seems cool.
b. Cons: Wifey is not a fan of the area. Low procedure numbers (per resident on IV day: residents get chest tubes in OR with cardiothoracic surgeons in order to fulfill ACGME requirement) because it’s a super academic program with all specialty residency programs. Surgery runs trauma (EM gets airway). One of the residents couldn’t tell me what he is proud of regarding the program which was a red flag. Get pushback from admitting/inpatient teams, standard Academic hospital nonsense. Far away from home.
Anything else to add?
I have been several thousand miles from home for the past 4 years so the real basis for my list is being back on the West Coast, wife happiness since she sacrificed a lot to move across the country for me, and clinical training. So,.......... I'm trying to get back to the West Coast. Therefore, I ranked many high-quality programs low solely because they are far away independent of their caliber.
For you MS3s/early MS4s....prepare diligently for your SLOEs (1-2 weeks of familiarizing yourself with common chief complaints/DDz/work-ups and be confident even when you have not idea what to do, and work really hard during shifts) because they will straight up make or break your application.
Programs whose interviews you declined:
I have been several thousand miles from home for the past 4 years so the real basis for my list is being back on the West Coast, wife happiness since she sacrificed a lot to move across the country for me, and clinical training. So,.......... I'm trying to get back to the West Coast. Therefore, I ranked many high-quality programs low solely because they are far away independent of their caliber.
For you MS3s/early MS4s....prepare diligently for your SLOEs (1-2 weeks of familiarizing yourself with common chief complaints/DDz/work-ups and be confident even when you have not idea what to do, and work really hard during shifts) because they will straight up make or break your application.
Programs that rejected you:
All the ""legendary"" programs
🙁
Note from @Stephanopolous : To anyone who would like to contribute or change anything, you can also PM me your ROL or any other information that was left off your submission on the spreadsheet. Your anonymity will be maintained.
245 × 133
320 × 180
640 × 360
