John H. Stroger of Cook County Hospital Residency Reviews

[EctopicFetus]

Ill chime in..

Res- Good community program. Residents are truly happy, I know one of their 2nd yrs and when I saw him on the wards during yr one he told me how much he loved it. Here is an excerpt of a previous post I made on Chicago Programs. I interviewed at Res and I think it is an up and coming program. It is a suburban hospital and while many of their past grads stayed within the Res system they are starting to make a bigger national name for themselves. They are churning out a ton of research. (I think when I was there they said they presented more stuff at ACEP than all of the other Chicago programs COMBINED). The hospital itself is nice and the nurses are solid. They claim they do NO SCUT. The facilities are nice and relatively new and updated. The attendings and residents seem to get along well.

Cook County - Ill give you my $0.02 on Cook County where I rotated. The place is completely busy. There is usually little time to rest. The pathology is at or near the best you will see in the nation due to the people who the hospital serves. The ED is divided into Red, Blue and Green. Red is generally the most sick people, blue is less so and of course green which is fast track. There is no shortage of opportunity for procedures. The traumas are brought into a special trauma area and I didnt have the opportunity to rotate there. They also have a dedicated 24/7 Peds ED. The attendings are great and you get a lot of autonomy. Since the program is a 2-4 the residents are more experienced than at other programs (I also rotated at ORMC which is a 1-3). The teaching is like anywhere else, it is dependent on who you work with. One of the attendings I worked with was absolutely amazing! Always willing to teach and always making time for it. They are starting a big push with ED US but you could say that about a lot of places. They have dedicated time to US each yr (I think). One of the attendings there (Dr. Cosby) is apparently the ED US goddess. I believe she has a book coming out soon on the subject. I worked with her and she was quite excellent. Being Cook County they send their grads all over the country and from what they were telling me that have no probs getting jobs anywhere in the country. The residents seem happy and get along quite well. The seniors basically run the whole show by themselves and seem to barely (I never saw it once) need attending help. The downside is that there is some scut. You will see attendings etc pushing patients to the CT scanner (which is real close). The staff is both a little slow with their work and also extremely busy! In the end I think the training has to be second to none! I hope this helps. If you have specific questions I would be happy to answer them. The program seems strong top to bottom!

Orlando - I rotated here and it has more of a community feel than a crazy county feel. The ancillary staff is amazing. I did NO scut there. The attendings are incredible. Dr. Rothrock who wrong the Pocket EM and Pocket Peds EM is there. The asst Program director sorta runs the show and he is great to work with. The residents get along great and really enjoy their time in the city.

I'm pretty tired so I wont go on but as always I would be happy to answer specific Qs about ORMC or any of these other places. This thread is a pretty good idea IMO.

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[thenewguy81]

Cook County
Residents: Huge class .–. 18 residents in a 2, 3, 4. Unable to get a good grasp on the residents since only 4 came out to the dinner and 4 came to the lunch. Not really sure what to make of this?

Faculty: Dr. Bowman had a very warm and casual presentation at the beginning of the day. He was very upfront in telling us what Cook has and does not have to offer their residents, i.e. great training vs. lack of funds. The interviews were all low-stress and all the faculty per the residents are interesting in teaching. Although, they do admit that teaching does get lost in the shuffle when you are a juggling a crowded room.

Facilities: Cook County is surprisingly modern, as they have a computerized tracking system and have decent ultrasound equipment. County has a separate trauma bay that is managed by a trauma team built of EM and trauma surgeons; so you will not see traumas in your regular EM shift. The peds ER is a little dingy when we saw it.

Curriculum: A 2, 3, 4 program .–. I think this puts a lot of people off. The off-service rotations will work you, but it sounds like oftentimes you are the leader on these teams. Now this is either a positive or a negative, as you get a chance to lead vs. learning from other specialties. Trauma sounds like it was strange at first, but all the residents swear that it is not a problem and that you invariably get sick of trauma (which is what you want). The peds experience is average .–. I think some of the residents mentioned it was a program weakpoint. But you do get farmed out to Children.’.s and Comer.’.s (which is pretty common for most Chicago programs). Also, it seems like this ER goes out of the way to not consult surgical services (which I think is a plus). For example, all ortho reductions (unless open) are done by the EM resident on duty. I think the clinical training you would receive is phenomenal, but they definitely throw a lot at you quickly.

Patient population: County is infamous for its underserved population. I think you see a lot of bread and butter EM as well as a lot of end-stage patients. You really could not ask for a better population to learn EM from.

Overall: Cook will attract a certain type of person - I think when you leave County you will be an EM cowboy, but the question you need ask yourself is if you need all that training. One person was relating that on his very first EM shift he was handed 14 patients at sign-out! I personally think I would love it and am going to rank Cook highly - just need to find a cush TY year 🙂. I think you would be hard-pressed to match the clinical experience of County. The two clear downsides are: 1) 2, 3, 4 format, and 2) the ancillary staff .–. while not the best, the most scut residents claim to do is push patients to xray.

 

[Chartres]

Getting caught up now that my SICU month is over...

Emory
[+] Residents were really friendly and nice at the night before dinner; training at both community and county hospitals; Grady seems like an awesome place to train with a lot of trauma and pathology(added bonus: there's a small gym in the hospital for residents); lots of ED time in the first year (6months); administration responsive to resident complaints (recently changed their ortho month to an ortho-ED month because the residents didn't feel like the ortho service month was beneficial) Great diversity among residents. The program goes beyond simply providing care to the indigent by offering multiple opportunities to get involved in community service. The residents have programs that collect clothes for trauma victims and there are multiple free clinics to volunteer in.

[-] Surgery does all the trauma team activation FAST scans, which I feel like is an important thing for an ED resident to become comfortable with. They say that there are enough traumas where the trauma team isn't activated that the ED residents get enough FAST experience. Grady's financial situation is shaky...supposedly being resolved and everyone says it can't close, but I remember hearing the same thing about MLK.

Cook County
[+] Couldn't make it to their happy hour, but really liked the residents I met during the day. The ancillary staff seemed nice and helpful too. The faculty appears to be very supportive of the residents. Their ultrasound program was really well-developed (they beta test machines for GE). They have a cool MICU month where the ED resident acts like the fellow and doesn't have to write notes; just does procedures and codes. The residents get TONS of procedures overall.

[-] The responsibility level is very sharply graded. The progam seems to be structured more toward immersion in a single area, rather than spread out over four years. (For example, trauma is done as an off-service rotation. The volume is high enough that the residents get lots of exposure during this time, but are not otherwise part of the trauma team)

LSU-NO
[+] Really liked the faculty here. They seemed very open and honest about the program's strengths as well as the drawbacks. The residents seem happy. The ED is new and fully functional. The pictures they showed of working immediately post-katrina were intense and made me feel like this is a program that would really prepare you for anything. They alternate trauma responsibility with surgery. You can moonlight and there are a lot of well-paying opportunities. They have some really interesting research going on.

[-] The residents told me that as an intern you are primarily responsible for running codes at one of the community hospitals. While I love autonomy, I'd also like to have someone more senior standing behind me in case I got into trouble. New Olreans as a city lost a lot with Katrina and it hasn't all come back.

Ohio State
[+] LOVE the faculty here. They are totally supportive, intelligent and dedicated to the residents. The ultrasound program is a real strength. This program also has incredible peds exposure. The ED is very nice and charting is done on computers. The residents are very friendly.
[-] The patient population isn't as diverse as some other hospitals.

 

[sleepymed]

This is my last interview, and no one seems to have covered this place... so H24G, this one is primarily for you (because you were giving me such a hard time earlier!)

Residents: I missed the pre-interview dinner because of chicago weather! I was really bummed about this, because I feel like that's when I really figure out whether I fit into a program or not. There are 17 different residents in each class and they seem like a relatively diverse group. I couldn't really tell how well they got along as a group... I was interviewed by two chiefs who were very nice... the usual chief interviews with the interview focusing on what the applicant wants to know about the program.

Faculty: The faculty I met with were pretty great. The program director was a great guy... his theory is he wants to train EM doctors who will be able to work anywhere. His interview was very, very laidback; and I really felt like the purpose of the interview was to get to know me. The assistant program director was equally as nice, but just slightly more intense (very, very slightly!). I was also interviewed by the director of U/S... overall, i was impressed with the faculty that interviewed me, they seemed to have a good vision of the program. Because I didn't rotate here or spend anytime in the ED, I can't really comment about what it's like to work with them. The residents I met seemed to be pleased with their attendings, and we sat in on a lecture... she was a good lecturer, i was impressed.

Ancillary staff: According to one of residents that I spoke to, the nurses are the worst part of the program... but as a disclaimer, this was only ONE resident, so take that with a grain of salt. They are a county program, so they of course need to deal with their usual amount of scut that comes with being a county program.

Curriculum: This is the part I'm least comfortable with. They are a 2-4 program that is working on converting to a 1-4 program, and their first year is in essense a medicine pre-lim year done AT cook county. Cook county's ER is phenomenal... Cook County's medicine program is not as great... and to spend a whole year doing medicine work there; i'm not quite sure how I feel about that. They have the usual lectures in the ED (the five hours that everyone has) except that they have it divided up over two days. They have the usual 2 ultrasounds. The residents work eight hour shifts, but the shifts are hard shifts. The find out their schedule several months in advance.

Facilities: I was pleasantly suprised when I saw their ED. The building where we have the interviews is kinda run down, so I expected the ED to be run-down, but they have recently opened up their new department and it looks great. They also have a huge trauma bay (biggest I have ever seen) but the trauma bay is staffed by surgery attendings, with EM residents joining the team only during their trauma rotation (i think they have one rotation as junior and one as a senior, but i'm not sure about this).

Location: Chicago is chicago... it's a great city to live in for about 7 months out of the year... the winter is VERY cold! By the way, when you come to interview here, bring a warm coat, because you have to walk outside!! Most residents drive cars, but apparently you can get along just fine with public transportation.

Negatives: I don't like the idea of having to do a whole year of medicine during my first year... not sure whether the name and the awesome EM training will be able to sway me to rank this higher or not... i need to do some soul searching!

Overall: Very impressed with Cook County. It is a county program with the usual good and bad stuff that comes with a county program; since I am interested in a "county" feel to whichever program I end up at, I liked it. I think they train fantastic EM doctors who are in high demand and can basically go work wherever they want. I would be very happy if I ended up matching here, but I really feel like I don't know this program as well as I know a few of the other ones that I interviewed at. Anyone have anything else to add/correct?

 

[WallowaWanderer]

Curriculum: This is the part I'm least comfortable with. They are a 2-4 program that is working on converting to a 1-4 program, and their first year is in essense a medicine pre-lim year done AT cook county. Cook county's ER is phenomenal... Cook County's medicine program is not as great... and to spend a whole year doing medicine work there; i'm not quite sure how I feel about that. They have the usual lectures in the ED (the five hours that everyone has) except that they have it divided up over two days. They have the usual 2 ultrasounds. The residents work eight hour shifts, but the shifts are hard shifts. The find out their schedule several months in advance.

Just curious . . . How does their R1 year break down - the website is quite vague. How many general medicine months? ED months? any ICU, anesthesia, EMS?

 

[sleepymed]

Just curious . . . How does their R1 year break down - the website is quite vague. How many general medicine months? ED months? any ICU, anesthesia, EMS?

The R1 year is basically a Medicine prelim:

1 month ID, many, many floor months, 3 months in the ED; the only difference between the Cook County IM prelim and the R1 for EM is that they don't have to do a month of out patient clinic:

5-6 rotations of general medicine inpatient care
1 rotation of MICU
1 rotation of ER
1 rotation of HIV inpatient ward
3-4 rotations of other electives
1 four-week block of vacation

 

[deleted52758]

hi, im one of the intermediates at cook county, and for the most part, everything is fairly accurate. the whole conversion of the program from a 2-4 to a 1-4 is going to be interesting, to say the least. i know alot of it hasnt been fully worked out yet, and if it has, it hasnt been conveyed to us (because it really doesnt matter to the residents). but, one thing i do have to say, is that i REALLY trust our faculty leadership in developing an excellent curriculum. i think the program will only offer you a stronger, more consistent training, by becoming a 1-4.

i guess other things, the nursing isnt that horrible. yes, sometimes it is. and there are the bad nurses, but im sure almost every county hospital has them.

trauma, we do 4 weeks as a jr, 6 weeks as an intermediate, and 4 weeks as a senior. by the time you're a senior (and often times as an intermediate) you are running the front trauma resus room, and staff them directly with the trauma attg. it's a good team approach, and for the most part, the trauma attgs appreciate what we bring to the table. and seriously, our trauma attgs are some of the national leaders, in terms of the amount of literature produced, so you get great teaching.

anyways, if you (or anyone else) has more questions about the cook county program, feel free to PM me.

 

[abbaroodle]

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[RxnMan]

This is a review sent to me by a SDN user who interviewed there and wishes to remain anonymous. I am posting it verbatim as a service for the SDN community.

Cook County Review

Pre-Interview Social: The dinner was at the Union Park Lounge. There was a good resident turnout, and one of the residents mentioned that they help pay for the dinners out of their own pockets. I thought that spoke very well of the residents but might be kind of concerning for the financial state of the program.

Interview Day: We started at 7:45 AM with breakfast and the PD going around the room asking all of us tell something interesting about ourselves. We then went to the departmental conference, toured the ED, and then came back for a presentation about the program by the PD and chair. This was followed by interviews and lunch.

I had five interviews with the PD, three other faculty, and a resident. The interviews were 15 minutes each. All of the interviews were pretty relaxed. I was asked why EM, where do I see myself in 10 years, what I do for fun, why medicine, and tell them about myself. Everyone also asked me what questions I had, so make sure you're prepared to ask questions!

Curriculum: Cook County is a four year program. Shifts are 8 hours with 20 shifts per block. They go to a ton of hospitals! The main one of course is Cook County/Stroger (county hospital) but they also do rotations at the University of Chicago (they do two PEM rotations there), Children's Memorial, St. Anthony's (OB/gyn), and several community sites (Our Lady of Resurrection, Evanston, West Suburban, Glenbrook). There aren't any official integrated peds shifts, but they do peds EM blocks every year, and they also see peds cases at the community hospitals. There are 29.5 total months of EM, including five months of peds EM. There are three months of ICU.

The intern year starts with a two week orientation where they do didactics, labs, ER shifts, and get to know each other. (There is a second orientation block in PGY2.) Cook County was formerly a 2-3-4 program that was recently converted into a 1-2-3-4 program, and their intern year is still very heavy in floor months: three blocks of IM and one block of inpatient ID (mainly working with HIV patients). The residents said that they get to do a lot of LPs during the ID block. Other off-service rotations are a block each of anesthesia, OB, and ortho. There is only six weeks of elective time, but two weeks of it is during intern year, which is pretty cool.

Most of the major EM subspecialties are covered, including tox, trauma, U/S (residents can get credentialed). There isn't an EMS block, but they have a base station course during intern orientation to introduce them to the Chicago EMS, and the residents do radio medical control after that. For trauma, they don't do very much as PGY1s, but then they do plenty of it during the second part of PGY2 year and PGY3. The trauma dept. is independent of the surgery dept., and it's also in its own area separate from the ED.

The PD mentioned that teaching is a major focus of the program, and the residents are trained to teach and supervise. They don't have any specific teaching blocks, but it's a general expectation that residents will teach students and EMS personnel. The responsibility is progressive, where PGY2s start doing resuscitations and PGY3s start supervising. (The PGY3 is the senior MICU resident.) The general focus is on dispo and learning to make decisions (i.e., when to admit or discharge). Also, Cook County is starting a brand new program of "colleges" beginning with our intern class. The purpose is to help with mentoring residents. There will be breakout sessions during weekly conference, and it's an opportunity for residents to get extra training in an area of interest and get involved in that area with a scholarly project, didactics, etc. I'm not sure how many colleges there will ultimately be, but there are at least three planned in tox, U/S, and EMS.

Didactics: Didactics at Cook County seem pretty good, both from what we were told and what I experienced at the conference I attended. Their didactics are often case-based and include M & Ms that are precepted by faculty with a resident presenting the case. They do a cadaver lab every year. There are also monthly readings, a monthly test, an in-service review, mock oral boards once per year, monthly sim cases, and a monthly journal club. However, they emphasized that the program does not teach to the boards.

Benefits: Benefits are pretty good, although the salary is not very high given the COL in Chicago. However, they get full medical and dental benefits, as well as $950 per year for academic expenses, a meal allowance, and support to attend EM conferences.

Administration: I really liked the PD and feel that this program is very supportive of residents. Besides the new colleges that they're starting to give residents extra mentorship, interns also get an upperclassman "buddy" to mentor them. There is a 36 hour retreat every year that all residents attend. Another interesting thing that I learned is that the housestaff at Cook County are unionized. I'm not sure what the costs and benefits of that are. The PD emphasized that they are looking for residents who are service-oriented, self-motivated, value diversity, and like challenges. And fun-loving, of course.

Chicago: Winter isn't exactly the greatest time of year to visit the Windy City, but Chicago is a fun place with tons of things to do and great food. You pay for all those amenities with a relatively high COL though. I don't think you could afford to buy a place unless you live way out in the suburbs somewhere.

Summary: If you are looking for a quintessential county program, Cook County is one that you should definitely check out. It seems like trauma is one of their biggest strengths, as is getting a ton of procedure experience. They also do a surprisingly large number of community EM rotations, so if that's your goal, you will get plenty of community experience here. However, at the same time, they value research and want to increase their research output. (Apparently the biggest obstacle they have is due to financial issues.) Their tox and U/S programs are strong too. I really liked the idea of the colleges and think they will do a lot for helping residents be prepared for fellowships in their area of interest. It seems like there is plenty of mentoring and emphasis on resident wellness, and they have a lot of pride in being a service-oriented program that sees a lot of uninsured poor and working class patients. The PD felt that another benefit to seeing this patient population is that residents get a very good understanding of health care policy. I thought the conference that I attended was well run and fairly interactive as opposed to just being a lecture. It seems like there is more emphasis on didactics at Cook County than there was at the other county programs that I visited. The ED is well-respected in the hospital, and they have admitting privileges to IM and surgery. They're also going to start using an EMR in February, so it will be up and running in time for our class.

For cons, of course a lot of people are going to be turned off by the extra year and the floor months. I'm still not convinced about the value of so many floor months, but I do think the extra year can be valuable if you're interested in an academic career. Plus, interns aren't required to take call during these IM months, which would make them a lot less painful. Also, I don't think I want to live in Chicago. It was fun visiting, but it's expensive to live there, and the stipend you get doesn't go very far compared to other Midwestern cities. They also go to a ton of hospitals all over the place. And I'm kind of concerned about how strapped for cash the program is when you have scenarios like the residents chipping in to help pay for the pre-interview social events.

Overall I liked the people and the mission of the program, and for sure I would get excellent training there. But I think there are other programs that are probably a better fit for me.

 

[Medtraveller43]

Can anyone comment on moonlighting policy here? I can't seem to find it in any of my notes and dog remember it being addressed during the presentation?

 

[django7]

while i was doing my trauma surgery elective at county the ER residents would be q3 while on trauma

 

[Medtraveller43]

Thanks for the reply! I was more interested in their ability to moonlight (either in house or out) to make extra $. Does anyone know if the residents moonlight here and if they do when they are allowed to start?

 

[django7]

sorry dont have specific info but the ER chiefs (PGY-4) would be moonlighting at a couple chicago hospitals. dont recall any juniors residents moonlighting

 

[blackavar]

Thanks for the reply! I was more interested in their ability to moonlight (either in house or out) to make extra $. Does anyone know if the residents moonlight here and if they do when they are allowed to start?

We have one in-house moonlighting opportunity where we work at the cook county courthouse medical clinic doing medical screening exams and helping to complete various paperwork. It's not glorious, but pays well for the actual amount of work involved. You can do this as a PGY-3 or PGY-4.

Externally, you can moonlight anywhere as long as there is double coverage. Only PGY-4s in "good academic standing" are allowed to moonlight. Everyone that asked to moonlight and applied was able to, which was about 1/4 of the PGY-4 class.

 

[imddr16]

Long time lurker, posting on alternate account in order to remain anonymous. These threads greatly helped me and as such I am paying it forward. Good luck for future medical students. I won't go into the curriculum details or specifics since those are mostly readily available on their websites, but rather I made a long pro/con detail list along my interview trail and I will highlight my thoughts from that list.

Pro: amazing training and autonomy, invested faculty, happy fun residents, obviously fun city with everything at your finger tips, family friendly, reputation is second to none, ER was nice but felt old, clearly excellent trauma experience

Con: chicago, cold, expensive, crappy salary, 4 years without justification, IM month, felt like lifestyle wasn't as balanced due to hours, admin stuff is in old worn out buildings, not very amenable to moving a family in the area, short on ancillary staff, interview day was a series of rapid fire interviews and due the volume I felt like I was a number and a stat, screwed up my interview broker and I had to make urgent changes as they were very inflexible

Overall impressions
Gut feeling: 6/10, would be well trained here for any job, not sure if the 4th year is justifiable
Facilities/resources: 6/10, felt old and dated
Location: 7/10
Didactics: Can't comment
Prestige: 10/10
Research: 7/10, they have research but its not an academic powerhouse like I was expecting from such a stellar reputation
Shift/hours/wellness: 7/10

 

[ibuprofelin]

Anyone know how peds works? Couldn't quite suss it out from their curriculum... Is it longitudinal or just dedicated blocks + the peds you see in the community months?

 

[Countydoc34]

I'm a current resident at county - happy to answer peds questions. We have one month of dedicated peds each year - one at county as an intern which will be changing soon (I'll explain later), one at Luries Children's (NW) and two at Comer (UofC). We also see peds overnight in our adult ED and mixed in at our community rotations (Glenbrook, Evanston, Community First, RUSH, W Suburban). They also send all the critical kids to our resus area, and while not common we've had a couple status kids/intubations over the past few months. The county peds ED is experiencing a good bit of atrophy as kids covered by Medicaid can go elsewhere, but we do see some still. It's pretty political and over my head but I think we'll be finding another outlet for our interns soon. For what it's worth the county peds month does give you an opportunity to learn our system/hospital some and work on your flow in a less stressful and lower volume environment. Programs with their own children's hospital and longitudinal experience probably have somewhat better training but I think the Comer months are fantastic and their faculty are quite good - nice bread and butter peds in an urban environment and a great peds trauma experience. We see peds on our trauma months at county too. Overall, I definitely feel adequately prepared for peds tho, and I would take our experience over NW where all peds shifts are at Lurie (kind of passive agreesive, hand holdy, zebra heavy, and consult city) - most NW residents would probably back that up although the do get a PICU month which is nice - not hating on their program tho as it is solid overall training as well. Anyway, as a 4th year resident, I have really enjoyed my experience at county - we are very well trained, get great jobs and have a collegial, fun environment to learn and serve a population that needs us - id be happy to answer any questions anyone has via this thread or direct message. And Go Cubs Go!

 

[EMreviewer2018]

Pre-interview Social: Wasn’t able to make it due to a flight delay, but friends told me it was fun and well attended.

Interview Day: A relatively short well scheduled interview day. Day started at 8am with a presentation by residency leadership that basically went over Cook’s moto of treating the underserved, history of the program being long and well known as well as explanation of colleges within the residency program for residents to focus on certain academic topics in PGY2-4. During the presentation different topics were covered such as why go to a 4 year program which the PD stated is better because you get more experience and knowledge and offservice time to broaden your differentials etc. During this meeting the fact that Interns do more offservice than most other programs was discussed and the PD basically stated this was because the EM program used to be 2-4 there with most residents doing an IM prelim beforehand so when he turned it into a 1-4 program he made a deal with internal medicine to keep EM interns around in IM longer than most other programs. Everyone explained they liked cook because of atmosphere of family and work hard play hard attitude and stated they have great nursing etc, but they do have to do a lot of the scut work themselves simply because they have so many patients. In terms of interviews themselves 5 15 min interviews that I felt were a little odd compared to most other places. Did get the feeling that interviewers knew my application better than other places, but interviewers asked less questions about it and would instead ask if I had any questions for them 5+ times which made me run out of conversation fast. Tour was standard as was the residency presentation. Interview day was surprisingly barren of residents with only 1 giving the tour to 20 applicants (2 groups of 10) and 2 more joining for the presentation.

Curriculum: A lot of my gripes about cook county stemmed from curriculum. Their 3 year vs 4 year argument was weak to me because they basically just said you’ll work more and be better for it, also their strict graduated responsibility seemed stifling at times as well. Some residents did comment that it can be aggravating having procedures and such taken by upperclassmen when you’re a junior resident but by the end you “see why it’s that way”, but I never got the impression that procedures were rare at county so you’ll get plenty no matter how they set it up. 2 months of IM floors and 1 month of HIV floors seemed odd remnants of the old prelim year to me and no longitudinal peds wasn’t great either. Cook doesn’t seem to get a lot peds in general (peds ED was quite small), and residents go to Northwestern for more peds experience 2nd year and then to U Chicago for 3rd and 4th year for I believe 4 months of peds experience total. Shift schedule seems fair all 8s. 18-20 on average and residents seemed happy with that as they got to live a life with 8s vs. 12s they said. Trauma is entirely outside the ED which I personally didn’t like as you have nothing to do with any traumas unless you’re on the trauma service which you do time on spread out multiple years including PGY4. Residents stated you see more than enough trauma which I doubt anyone is surprised about at Cook County, however, their hours sounded horrible with 36 hour shifts q3 and residents stated they were awake for pretty much all of it and they only get 12 hours off after their 36 hours as they expected to come the next day at 7 to still round on their patients before reporting for their next 36 hour shift! Surgery entirely runs the show here and no EM attendings staff the trauma room. PGY3s and PGY4s start rotating outside of Cook at Glenbrook and Evanston to get a more community feel and apparently really enjoy it.

Facilities: A mix of super old and newer (early 2000s) spaces. Physical ED is relatively nice classic curtain ED with some people in hallways. 4 beds for observation overnight. Have all the toys you could want with C arms, multiple US machines etc. Nicer than I expected actually. Forget the name of the EMR but it’s not Epic and there is no Dragon. All residents get 19$ a day for food on all services including at other hospitals! Research seems good, but not great here. Apparently they have very few grants so you have to be very motivated to do it, but that being said it’s not like people aren’t publishing in big journals here, maybe just more resistance than other places.

Overall I felt a little underwhelmed by Cook County in general. The people were very nice and I’m certain their reputation goes far in the EM world, but nothing other than having a huge trauma bay seemed that unique about it, nor did I get the feeling that their 4th year added to the overall experience and rather they just forced things to be spaced out and stated the residents were overall better for (which may very well be true, but I wasn’t convinced). The trauma which is a real strength of the program sounds educational, but extremely difficult and may be even a bit overkill hours wise and I think I’d miss the spontaneity of a trauma coming to the actual ED and the lack of longitudinal peds seemed like a big negative to me. I do see why it’s known as such a great program, but personally don’t see it as the program for me.

 

[WildcatS11]

Pre-interview Social: Wasn’t able to make it due to a flight delay, but friends told me it was fun and well attended.

Interview Day: A relatively short well scheduled interview day. Day started at 8am with a presentation by residency leadership that basically went over Cook’s moto of treating the underserved, history of the program being long and well known as well as explanation of colleges within the residency program for residents to focus on certain academic topics in PGY2-4. During the presentation different topics were covered such as why go to a 4 year program which the PD stated is better because you get more experience and knowledge and offservice time to broaden your differentials etc. During this meeting the fact that Interns do more offservice than most other programs was discussed and the PD basically stated this was because the EM program used to be 2-4 there with most residents doing an IM prelim beforehand so when he turned it into a 1-4 program he made a deal with internal medicine to keep EM interns around in IM longer than most other programs. Everyone explained they liked cook because of atmosphere of family and work hard play hard attitude and stated they have great nursing etc, but they do have to do a lot of the scut work themselves simply because they have so many patients. In terms of interviews themselves 5 15 min interviews that I felt were a little odd compared to most other places. Did get the feeling that interviewers knew my application better than other places, but interviewers asked less questions about it and would instead ask if I had any questions for them 5+ times which made me run out of conversation fast. Tour was standard as was the residency presentation. Interview day was surprisingly barren of residents with only 1 giving the tour to 20 applicants (2 groups of 10) and 2 more joining for the presentation.

Curriculum: A lot of my gripes about cook county stemmed from curriculum. Their 3 year vs 4 year argument was weak to me because they basically just said you’ll work more and be better for it, also their strict graduated responsibility seemed stifling at times as well. Some residents did comment that it can be aggravating having procedures and such taken by upperclassmen when you’re a junior resident but by the end you “see why it’s that way”, but I never got the impression that procedures were rare at county so you’ll get plenty no matter how they set it up. 2 months of IM floors and 1 month of HIV floors seemed odd remnants of the old prelim year to me and no longitudinal peds wasn’t great either. Cook doesn’t seem to get a lot peds in general (peds ED was quite small), and residents go to Northwestern for more peds experience 2nd year and then to U Chicago for 3rd and 4th year for I believe 4 months of peds experience total. Shift schedule seems fair all 8s. 18-20 on average and residents seemed happy with that as they got to live a life with 8s vs. 12s they said. Trauma is entirely outside the ED which I personally didn’t like as you have nothing to do with any traumas unless you’re on the trauma service which you do time on spread out multiple years including PGY4. Residents stated you see more than enough trauma which I doubt anyone is surprised about at Cook County, however, their hours sounded horrible with 36 hour shifts q3 and residents stated they were awake for pretty much all of it and they only get 12 hours off after their 36 hours as they expected to come the next day at 7 to still round on their patients before reporting for their next 36 hour shift! Surgery entirely runs the show here and no EM attendings staff the trauma room. PGY3s and PGY4s start rotating outside of Cook at Glenbrook and Evanston to get a more community feel and apparently really enjoy it.

Facilities: A mix of super old and newer (early 2000s) spaces. Physical ED is relatively nice classic curtain ED with some people in hallways. 4 beds for observation overnight. Have all the toys you could want with C arms, multiple US machines etc. Nicer than I expected actually. Forget the name of the EMR but it’s not Epic and there is no Dragon. All residents get 19$ a day for food on all services including at other hospitals! Research seems good, but not great here. Apparently they have very few grants so you have to be very motivated to do it, but that being said it’s not like people aren’t publishing in big journals here, maybe just more resistance than other places.

Overall I felt a little underwhelmed by Cook County in general. The people were very nice and I’m certain their reputation goes far in the EM world, but nothing other than having a huge trauma bay seemed that unique about it, nor did I get the feeling that their 4th year added to the overall experience and rather they just forced things to be spaced out and stated the residents were overall better for (which may very well be true, but I wasn’t convinced). The trauma which is a real strength of the program sounds educational, but extremely difficult and may be even a bit overkill hours wise and I think I’d miss the spontaneity of a trauma coming to the actual ED and the lack of longitudinal peds seemed like a big negative to me. I do see why it’s known as such a great program, but personally don’t see it as the program for me.

I just wanted to address the bolded above. Not a resident at county, but I know how trauma works there. Residents basically arrive ~ 7am, and if on call, then they hand all the traumas that come in until 8 am the next day, and leave after rounding/cleaning up the next day. 30 hours is the typical maximum. People (at least not the EM folks - sometimes surgery folks would) are not staying until 6 or 7 pm (which would 36 hours).

 

[BenignBeignet]

Recently interviewed here, here's what I thought/found:

Cook County: 4-year county program. Very strong autonomy here, all ED procedures are yours, including most ortho reductions. Slit lamp/tono- pen/ENT complaint area in ED. No EM-CCM faculty, but residents still match to CCM. Decent ultrasound, no TEE, ultrasound themed electives PGY4. Very intense/thorough trauma experience but is only on trauma months (1 trauma rotation every PGY1-4 year). Big on toxicology and EMS. Longitudinal PEM. Lots of support if applying to fellowship. Moonlight as PGY2. Biggest con here is only 6 weeks of elective in all 4 years (about the same or even less than most 3 year programs), which was a major turn off for me, but the reputation and faculty will still support you to get wherever you want.