University of Chicago Residency Reviews

[jigga_what]

UofC - interview day was pretty chill. Good selection of Krispy Creme and bagels. Dr. Howse showed up in his sweet black leather suit and proceeded to blather on for awhile in his typical fashion about boats, his family, martinis, etc. Some people were turned off by him, but he rather endeared himself to me. What followed was your usual program overview/slideshow and a touting of their strengths - long history, wide alumni net, varied clinical training sites (including one that was admittedly a long drive - lutheran, I believe). They are not level I trauma, so they farm their residents out. The also strongly emphasize their flight program, which is integral to their traning program. If you're an R2 in the ED, you're the flight surgeon on call. Airways, tubes, lines... all are fairly common on the whirlybirds. Con is that you have to dump all your patients on the R3. They also have an insurance-based, fixed wing version, where you fly across the ocean(s) to pick up sick people, stay a day in that country, then fly back. This counts as a shift, which is sweet, and the gravy is that you get paid $1K, for the trip. The department takes a cut before you get yours; this is how they pay for their MANY bar outings, parties, ACEP reunions etc... These people have fun. Oh, moonlighting after one ED month - working urgent care for $60/h. Chicago is fairly expensive.

Research isn't as big there, and I hear they're losing two of their top research docs next year (which they failed to mention on interview day, so be sure to ask). They have a new young faculty who is trying to establish some international stuff.... Oh, also, Howse is retiring in three years, after he finds us jobs.

In general, got good vibes there - residents were cool, good reputation, 3 years, but trauma seemed to be lacking a bit and it may require a little extra work to get a research project off the ground. Very good stuff overall.

Buena suerte con la entrevista...

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[waterski232002]

To the OP... Glad you're interested in the University of Chicago! I am a resident there, and am happy to offer my input. Our program is awesome, and I couldn't be happier.

For starters... there are tons of great programs, and you need to pick the one that is best for you. And DO NOT underestimate the importance of being happy with the CITY in addition to the PROGRAM. Honestly, I think a lot of my happiness it is due to the fact that I really love the city. I have tons of friends here outside of medicine, I'm close to family, and there is soooo much to do (bars, clubs, museums, beach, sports, you name it)... If you are happy away from work, you'll be much happier AT WORK.

On a more academic note, we are kick-ass and it's just that simple. Our program has created more program directors than any other program in the country (which means good connections, and lots of respect). We are also the oldest program in chicago, we have a required flight program, and over a third of our faculty are board certified in EM/IM or EM/IM/CC which is an excellent resource.

But probably the thing that makes our program stand apart, and the reason I decided to come to UofC, was the fact that we have extremely sick patients and we are a 100% resident run program. You can not say this for the other chicago programs. I am not saying that our program is for everyone, because it's not. Many people may not like what I describe from here on out, but this is what are program is like (for better or worse... you'll have to decide).

I would say that over 50 % of our patients are completely uninsured, and most only see a doctor when they're just sick as hell, and literally can't take care of themselves at home anymore. Our hospitals is in the south side, and we have the sickest patients in chicago--hands down! Lots of patients are very complicated, often having the full boat of CHF, DM COPD, ESRD on dialysis and in multiorgan system failure when they present to us. We see tons of septic shock, acute abdomens, uncontrolled CHFers, recurrent DKA's, etc. It is not your run of the mill ER, these people are sick. We run codes almost every day (some days multiple) and many of them actually code in front of us (as opposed to the dead nursing home guy EMS brings in that they've been doing CPR on for 40 min). It is truly a great experience.

The other awesome aspect is that attendings are very hands off. We run the entire show. If a patient needs intubating, the intern does it, and if he fails, than the senior WILL do it. If the senior is unable to intubate than it's time for the senior to cric the patient (not time for the attending to step in). Attendings literally just oversee and rarely get involved beyond popping their head in the curtain, asking a few questions, then adding their 2 cents. They are NOT micromanaging or even macromanaging for that matter. You can have a patient that is having an MI, in DKA, or who has an acute abdomen, and the attending may not see him/her for 2 hours (unless you pull the attending aside to let him or her know about it b/c you've got a question about something). I think this is great b/c it let's us do all the management and allows us to get used to making the hard diagnostic and therapeutic decisions. Of course your senior resident and attending are always available as resources, and the senior is there to help you with any jams you might have weather it's a question about an X-ray finding or deciding weather to CT scan an abdomen. The bottom line is that if you feel comfortable managing the patient, then you will have full reign on it. Think carefully about this... most of the top programs I interviewed at were NOT like this! Attendings at most other high end programs micromanage and will cut the resident off and take over when things get hairy. Again, at UofC, we run the show.

Overall, we really run more like a county ER, although we're in a huge academic center. We rarely consult other services, unless it involves admitting the patient. I think this is a big change from where I went to medical school. We have admitting privileges to medicine and cardiology, so we don't have to "ask" permission to admit. When we decide to admit the patient, we call Gen Med or Cards and TELL THEM that they're getting a patient, and what the story is. There is no such thing as a cardiology or medicine consult. In fact, there is no such thing as a renal, pulm, rheum, or derm "consult" in the ER either (or I have never seen one done for that matter). All the surgical specialties are consulted, but usually only for complicated cases or possible surgical indications... but the fact that gen med and cardiology are automatic admits takes away from a lot of arguing that I watched happen at other programs. We truly keep the consulting to a minimum.

The other hospital we rotate 1/3 of our months at is Lutheran General in the northern suburbs. This hospital is very different... patients tend to be insured, educated, and knowledgable. It is a level 1 adult and pediatric trauma center. Medicine is practiced very conservatively, patients are not very complicated, generally healthy with a single system complaint, more of a typical ER. This is where we see our classic uncomplicated appendicitis and cholecystitis... as opposed to the UofC specials where it is not uncommon to have them present as a perforated appendicitis with a retrocecal abscess or cholecystitis complicated by DKA, Seizures, and A-Fib with RVR. The 2 settings definitely compliment each other and lutheran there is much more attending supervision. Every patient case is discussed thoroughly and the attendings micromanage everything and will followup on the patients entire course in the ER, so everything is discussed and learning points are made all the time. Totally, non-resident run... if we weren't there, the ER would go on with no problem. The teaching is phenomenal.

Lastly, I also interviewed at Cook County and Northwestern in chicago and I like both programs, but they are very different. Both have excellent national reputations, that's why I interviewed there. Cook has sick patients, but tends to be diluted with the frequent fliers who seek all their primary care there and get their prescription refills in the ER. Northwestern has an excellent program as well and lots of EM/IM trained attendings, but they made it very clear that 80% of the patients they see are between the ages of 18-65 and tend to be affluent/insured, so they're just not as sick as some of the other chicago hospitals. I think I would have been happy at Northwestern as well, but the University of Chicago was a much better fit for me. If you don't want to work in a county-like ER, be given lots of responsibility and autonomy, and deal with sick patients, than UofC probably isn't the program for you.

Sorry this was long... but if you have any other specific questions, fire away...

Oh yeah.... And I didn't even mention the perks of the program... the flight program, moonlighting during 1st year, and our international patient transport program where they pay us $1,000 to pick people up from all over the world (paid vacation for residents!).

 

[crewmaster1]

Here's a brief review since I posted this in response to someone's questionon another thread:

DISCLAIMER: I did this interview over a week ago, and have done several since then. This is all from memory. Please feel free to correct me or add comments, just don't go nuts if I screw up some details!

In summary. I think it is a very strong program. The residents come from all over the country (not commonly seen in the midwest) and come from top notch medical schools(a big goal of the PD per a resident). Aside from a ton of details that can be found on their website, things that stuck out with me:

1. When you fly, you are carrying patients. This means you need to always be ready to sign out your patients to the R3 if you get paged. All the residents seems to feel fine with this and said it just means you are close with with R3 and keep each other updated frequently. I'm more a fan of dedicated/segregated flight shifts. I feel like having to fly and see pts would cause me to go about things in a different way. For example, I feel it would limit my ability to practice multitasking. I rarely as a med student saw a pt, made all the orders right away and completed the chart ASAP before I ever started things with another patient. But, if there is a chance you could get a flight and have to run, you better have that chart completed before you start messing around with a new patient. I think to be a efficient community doc (where you are earning your keep based on your productivity) you better be darn good at multitasking. In defense, the residents don't fly on all shifts....sometimes they are in one 10 bed room (can't remember what they call it) and they just cover the rooms, no flight. Also, during they day there is a "teaching R3 resident" that takes first dib on flights/ground transports, meaning you are less likely to fly. But when the R3 is out or you are working in the evening, your 1st up for a flight and better be ready. I wouldn't mind learning the skill of signing out patients fast, but I just don't see how I will ever need that skill once I'm out of residency.

2. The second thing that stuck out a little bit was the new "teaching resident". This is an R3 position that was recently added at the U of C hospital due to, in my opinion, what sounds like understaffing by faculty resulting in a lack of teaching. I applaude them on addressing the issue by adding an R3 and I think this would be a great experience as an R3 (1st up to fly and time to catch up on reading/EBM stuff/time to teach), but I would rather have the majority of my teaching from attendings, not a resident that only has 6-12 months more experience in the ED than I do! Plus it sounds like the R3 does a lot of procedure supervising for the interns and also sees their own patients.

3. Something like 10 of the 36 months are done at a second facility, Lutheran General, an upper class hospital in the NW side of chicago. This is quite a ways from the UC campus. Residents say the avg. commute is 45 minutes, but it can be as long as 1.5 hrs if snowing. Neither of the hospitals have good mass transit access. It sounds like the experience is awesome at this hospital (work 1 on 1 with an attending, see good patients, good teaching), but it is a lot of commuting. To make up for it, the shifts are shorter in the ED (I think 8 hrs on weekdays, and 12 of weekends), but it just means more time in your car, less time in the ED.

4. During the interview all the residents were very nice and answered a ton of my questions, but the whole environment wasn't that laid back. I really don't think it was the residents, but more due to the fact that UofC doesn't have a preiniterview dinner where you can drink beer and chill out and really get to know some people in an informal environment.

5. The UofC is no longer a Level 1 trauma center for adults, so you do trauma rotations at Christ. This again is a long ways out of town (45min commute). Sounds like a great experience, but you won't have as much level 1 trauma integrated into your regular ED shifts (if you even care). It sounds like they get plenty of trauma, and what the hell does trauma mean anyways. Its really about sick medicine patients and they see plenty.

 

[monkeyarms]

just want to point out that the u chicago review is wrong about trauma...they go to mt. sinai for trauma, not christ. as of 3 weeks ago when i interviewed there all 3 hospitals they rotate at were level 1.

 

[crewmaster1]

just want to point out that the u chicago review is wrong about trauma...they go to mt. sinai for trauma, not christ. as of 3 weeks ago when i interviewed there all 3 hospitals they rotate at were level 1.

You're correct. My bad. I interviewed at 3 programs in chicago in less than a week. My brain was a bit fried at the end of that. It is UIC that rotates at Christ.

Either way, at UC you're not working in a level 1 at the university hospital, for what that's worth.

 

[thenewguy81]

UChicago
Residents: No pre-interview dinner, so hard to gauge most of the residents. Before I came here many fellow interviewees told me that U of C residents were .“.a different breed..”. I never knew what that meant until I interviewed and the best way to describe the U of C atmosphere is one that seems more stereotypically medicine versus EM. But, I got along with all of them and would love working with them in the future.

Faculty: Dr. Howes, the program director is well-connected and states that it is his goal to get you a job you want by the time you graduate. However, he is retiring in two years, but will still be on staff and is grooming a replacement. The other faculty seemed pretty nice from the interview, but not as laid back as many of my other interviews.

Facilities: The U of C Mitchell ED is fairly old, but has an electronic tracking system and the facilities are definitely good enough for training. Also, they a 10 bed part of the ED that is brand new and is run by one attending and one EM and one IM resident. Also, there is talk about converting the old children.’.s hospital to an obs unit. The children.’.s hospital is pretty ridiculous .–. it is a close second to CHOP. It is only second to CHOP, because CHOP.’.s sheer size puts it over the top. As far as .“.modern-ness.”. they are equivalent and I think U of C receives all the level 1 children.’.s traumas on the South Side. Mt. Sinai is a community inner-city site that actually surpasses Cook County in trauma and residents spend 1/3 of their time here. The residents spend another 1/3 at Lutheran which is an affluent suburban hospital and a level 1 trauma as well.

Curriculum: A 3 year program with a strong academic reputation .–. which I think is a hard mix to find. The program de-emphasizes floor months (none!) and puts heavy priority on unit time your first two years. Beyond the unit and elective time, all your days are spent in the ED. The peds experience seems strong since you spend time at the Comer.’.s Hospital which just opened its new ED. As a 2nd year, you are the flight doc during your EM shift .–. meaning when you are called to fly you need to drop your patients (sign out to the PGY-3 and run to helipad.). There is also something called a teaching resident .–. an R3 (separate from the one on shift) teach procedures, cover flight shifts, and teach the students. I think the biggest plus with this curriculum is the autonomy afforded .–. the interns get first crack at procedures, , the R2 on flights is the sole doctor, the R3 runs the rooms, and the attending really just chips in when needed.

Patient Population: A good mix, as you see three different hospital systems ranging from the suburban to inner-city to tertiary-care issues.

Overall: The training provided seems phenomenal .–. I am a big fan of the flight experience, autonomy and strong academics. Also, the fact that it is a three-year program is great! It seems like you can go pretty much anywhere in the field from this program. The negatives are that there is a lot of driving involved and that I didn.’.t really feel like I knew what direction/mission of this program. I am not sure if that makes sense, but other programs emphasized academics, opportunities, clinical training, where they were heading in the future; something I didn.’.t experience here. I think I will second look this program, because I am going to rank it highly, but I still have questions.

Whew.….that.’.s it for now.…..I will eventually post NW and some others 😴

 

[SecretReviewer]

An alternative perspective (that's what this is for, right?)...

One, the residents at U of C were some of the coolest I've met after a number of interviews. So I would say they're a "different breed" in a good way. Maybe they can come off as Internal Med types in that they were very bright folks from big name schools--but they are definitely EM types.

Second, Rosen went from U of C to Denver way back in the day--so it has a good history of being both an old program where "the father of EM" was, and it is one that has trained a number of folks who have gone on to be PD's. I'm pretty sure there were 2 to 4 folks who go academic/fellowship each year. This compares well with other good to very good programs. So not an academic powerhouse, but definitely not a "community only" program.

 

[Hard24Get]

University of Chicago

Residents: 16 residents per year. Residents are involved with interviewing and leading the tours. Though there is not a night out the day before, there is a well-attended tasty 2 hour lunch that gives you plenty of time to meet the residents. This was better for many that were traveling. The residents themselves are awesome - happy, smart, and very fun. They openly admit you have to be a little crazy to work there (but in a good way 😉). They are diverse racially, geographically, and socially. A really great group!

Faculty: The PD is Dr. Howes, who has served for almost 20 yrs and will be stepping down next year to give someone else the opportunity to run the program, which he says is the best job in the world. He is currently grooming Dr. Tupesi, the assoc PD, for the position. Something tells me he will still be around quite a lot after he retires from being the PD, he isn't exactly a background kind of guy. Both seem extremely dedicated and the residents love them. They want future leaders and they are crystal clear about this. The rest of the faculty seems awesome as well, and are from all over. Big names doing great things. Residents say they are mostly on a first name basis with all of them.

Hospital:
So there is U of C, which has been said many times before is a pediatric, but not adult, level I trauma center. This may be a good thing, as residents are often busy caring for the sick 75K people that come in. Level I adult trauma experience comes from Lutheran, which is a pretty busy hospital (53K) with few other programs. This allows the EM resident to really take over. There is also a community experience at Mt Sinai.

Ancillary Stuff: Excellent by report, very little if any scut and a good relationship with nursing, etc.

Admitting/Documentation: There is occasionally some fighting with other strong programs to admit, which they say makes you a great patient advocate. Charting is paper at U of C and electronic at Lutheran.

Curriculum: 3 year curriculum with emphasis directly on ED time. No medicine floor month. It is all EM and critical care time. As is well known, you will fly as an EM 2 and some EM 3 during your shifts, and be the doc in charge, since U of C runs Chicago's flight program. People have complained about having to sign out your pts in the middle of a shift, but I think it is nice to have a modality for independence as it establishes confidence. It also opens the door for well-paid medical transport flights to other countries, etc. Shifts are 8 or 10 hrs with 12hrs on the weekend so everyone gets 2 weekends off.

Didactics/Research: Didactics are once a week and modular. There are also simulations and a medicolegal course. U of C is very strong in both clinical and basic science research (mainly reperfusion injury), and they even have a new physician-scientist track!

City: It's Chicago - beautiful, fun, and cold. You decide. 🙂

Extras: Salary is 41K+ with good benefits. There are opportunities to moonlight in the fast track beginning in the 1st year! There is also flight doc money, book money, etc. The program will really go to bat for you in terms of getting jobs, and graduates are highly recruited and kick butt (they say 25% of EM PDs went to U of C).

Negatives: One man's trash is another man's treasure, so it is difficult to say. People often cite the primary hospital not being a level I trauma center, having to fly, and even Chicago as negatives. A truly great program like this doesn't have obvious flaws. Pick your poison.

Overall: The PD is an amazing, driven resident advocate that carefully crafts his resident classes and nurtures them for an amazing career using a EM/critical care heavy curriculum, flight program, and varied clinical sites. They make no bones about looking for future leaders, and it seems clear this is the best program in Chicago for academic medicine. And this program is for Bad a$$es only 😎. Definitely check it out!!!

 

[colicky]

University of Chicago: I enjoyed the interview there with the PD and faculty. PD was very approachable! Did not rotate here. one of the top tier programs in my opinion. You work a 3 places, hence, getting a variety in your experience. Heard great things about mt.sinai rotation. Residents get lots of procedure especially at Mt.sinai i have heard. Good CV research going on at UC. Hey it's Chicago!

Case-western/Metrohealth: Interviewed and rotated at this joint. Combined program with cleveland clinic. I rotated at the metrohealth side. My interview went well. I especially enjoyed my interview with some of the faculty from the Cleveland clinic as it was fun, and most of the faculty joke and very laid back; they do like to name drop that cleveland clinic as one of the best hospitals in the country. I enjoyed the faculty when we toured the cleveland clinic. My rotation at metrohealth was ok; faculty don't usually joke that much, and don't look like they are enjoying work. My ideal place would be where people are enjoying work and are having fun while being at work. After all it's EM, that's why we are going into this field instead of being surgical slaves. Watch out for the program director, from the shifts and teaching conferences, a total bully; usually threatening to residents, who look afraid of him and unhappy overall. The PD uses sarcasm to be judgmental about decision making of residents that is quite degrading. They do have nice teaching rounds everyday at 11 am during shifts for 10 mins. Busy ED, probably 90-100K at metrohealth side, and 60K at cleveland clinic side. Both sides have a very similar electronic record keeping so don't have to learn 2 completely separate systems. Lot's of trauma experience can be a plus or minus.

Maimonides: Did not rotate, did interview. Their chairman is one of the old school guys/founder of EM field. Pretty good EMS system that services the program. I think they have subsidized housing. Don't like Yankees. The hospital is in a nice neighborhood. Not much trauma. Not much else to say.

 

[EvoDevo]

Albany

Basics: 3 years, 10 residents per year. No floor months – off services are 2w ob/anesthesia, and unit months. CCU sounds a little floor-ish (and you, for some odd reason, cross cover a certain group of private pulm patients). Also do MICU, SICU, PICU (2nd year for that last one).

Shifts: 9 hours – 20 as intern, then 19, then 18. 2nd year about 1/4 of your year is more dedicated to trauma (but in the ED – which I think is great) and you work 12s with a shift reduction. Residents said they usually end up with fewer shifts than listed above.

Peds experience is integrated – one of the sections of the ED is dedicated to peds. They have just hired two peds EM boarded attendings, but otherwise you are precepted by EM attendings for peds. You have one dedicated month in the peds section of the ED and pick up peds patients during your shifts.

The PD is a Pitt grad who worked to build the Maine program before coming to Albany. He seems great –young, friendly, great relationship with the residents. He's very outdoorsy – rock climbs, etc. and it seems like a lot of the residents do too.



UMass

Basics: 3 years, 12 residents, no floor months. Effective use of off-service months (do your anesthesia, intro flight shifts, and u/s all in the same month).


Shifts: 9 hours (?)

Residents: northeast, some from outside region. All I spoke with said it was their first choice. Seem happy – but not the most cohesive group I've met on the trail.

Cost of living – much better than Boston (some do live in Boston, though – some have SOs that matched there)

Overall amazing opportunities and dedication to training. Integrated peds in last two years (I think). Good community experience without a huge commute. Powerful dept in the hospital (as evidenced by brand new ED, dedicated space on floor below it). Good sim training. Something like 5 u/s trained (RDMS!) attendings and 8 toxicologists. Very strong U/S and tox experience. Dedicated flight shifts in 2nd and third year (bulk in third). Volume is somewhere around 80-90K and growing. Supervisory rotation as part of third year (but not the entirety of third year)

PD – dynamic, funny, very involved in recruiting next class of residents. The faculty are about ½ UMass and ½ elsewhere (impressive list from elsewhere)



Boston medical center – "county with resources"

4 years, 12 residents/year. Just converted to 1-4.

Curriculum – first year lots of off service. 2 months ward medicine (which the PD pretty much admitted to me he HAD to do in order to get his 1-4 program), 1 months floor surgery, then lots of more fun stuff (ENT, MICU). One of the stronger departments in the hospital. The ED is theirs – consultants are there at the program's invitation and all turf battles have been long since fought and won. Residents have no assigned role on ob/gyn and ortho. They said it's "You get out what you put in." Probably not an issue for ob/gyn (10 deliveries and out) but ortho seems like it could get tricky. Ortho has to see EVERY fracture in the ED so that they can f/u in clinic – so unless you are aggressive with splinting/reductions I'm guessing you could miss out on a lot of that.

Electives – lots of opportunities but funding is up to you. International opportunities abound if you can save or beg the cash.

Residents: from all over, all said it was their first choice. VERY personable, anxious to share why they LOVE BMC. Shifts are 20 12s PGY2 year (I assume this will apply to PGY1 as well), mix of 8s and 12s PGY3 (but busy – you run trauma this year), and 8s during week/12s on weekends PGY4 year (NO NIGHTS in PGY4). Some of those details could be wrong – I don't pay too much attention to shift length.

Sites – Quincy, Lahey Burlington, the old Boston City Hospital ED (HAC) is the main site, and then HNC (I think) is the old BU Medical Center ED. Volume at HAC is about 130K if I recall correctly. HAC is divided into 2 sections – acute side (chest pain, SOB, trauma) and the less acute side. PGY2s work on both sides, PGY3s run the acute side, and PGY4s run the less acute side. PGY2 you are the "procedure resident" and essentially do all the procedures AND cover your patients – seems like this would be crazy busy and fun!

PD – personable, funny, very unassuming. Seems to genuinely want everyone to find their "happy place" on the trail. Was very very very involved in interview day – which I appreciated. Interviews are 2 faculty (or residents) to 1 interviewee.

Overall: I think this is a fantastic program and I think it will only get stronger now that it's 1-4. I liked the residents.



BIDMC

Format- 3 year (optional jr attending year), 12 residents/yr

Residents: from ALL over (actually seems to be a lack of people from the Northeast), 12/year. All are personable and excited about their program, everyone I spoke with said it was their first choice.

Curriculum – 3 weeks medicine wards, otherwise pretty standard. 6w elective time – including a "teaching" week in Italy if desired. Their u/s and tox programs seem to be works in progress. Just started an EM critical care fellowship. Optional fourth year during which you work ½ time as an attending and can pursue research, further education (MPH, Kennedy school). About 1/3 of the residents take advantage of this.

Faculty – amazing names, lots of research money, faculty are mostly from outside (Hennepin, Denver). Peter Rosen (the textbook author/editor) is part time faculty. PD is Dr. Carlo Rosen. Graduate of Denver, first PD of this 9 year-old program. Seems like a good resident advocate. Residents are getting jobs in competitive job markets.



Advocate Christ Medical Center

Advocate Christ is a medical center in Oak Lawn, IL, a suburb of Chicago. The hospital itself is a big community hospital with many subspecialties. It is a busy (90K, I think) ED. The ED itself has a very busy community feel – lots of patients, some in hallways but with everything running fairly smoothly, good ancillary staff. The program has good ultrasound and tox experience. They do a LOT of EM months for a 3 year program.

The attendings are from all over – many from ACMC (also known as "Christ). The resources at this program are phenomenal. There is lots of funding for conferences, etc. The residents have produced a HUGE number of posters at academic conferences in the last few years. The residents are paid well, many live in Chicago and reverse commute to the suburbs. They are a very happy group – well protected on off-service rotations and treated well during their EM months. Overall I felt like this program is the "hidden gem" of Chicago. Be aware, though, that it's supposed to be tough to get an interview – they only interview 80 candidates per year.



Uof Chicago

Large program (18/yr, 3 years), longstanding and very well-established with a great alum network. The well-known PD (Dr. Howes) will be handing over the reins to Dr. Tupesis (current assistant PD) in July. Howes will be the assistant PD for a year while they find a replacement. UofC Hospital is a peds level 1 trauma center, but adult level 2 due to financial concerns (when they were level 1, they were getting ALL the penetrating trauma and couldn't afford it). I had my interview at Lutheran, so didn't see U of Chicago, but from what I hear it is a busy, urban ED. Residents spend about 10 months at Lutheran General, which is out near O'Hare and is a busy, level I trauma center. They work 1 on 1 with the attendings at Lutheran (as opposed to the graduated responsibility model at U of Chicago) and really seem to like their time there. You also do trauma (I forget how many months) at Mt. Sinai (community hospital located in a knife and gun club neighborhood). UofC as a whole also just affiliated themselves with the hospital at Evaston, Illinois. This is a big, tertiary referral type hospital that used to be affiliated with Northwestern. The hospital is best known (in the EM world) for it's simulation center, so that is one aspect of EM at UofC that will grow overnight.

I did not get a good sense for what tox and ultrasound were like at UofC. Overall I did feel that they made a very good use of time by not having an OB rotation, but instead having you take OB calls to get your deliveries during your EM months intern year. They also combine your anesthesia month with NICU call – so you can get your neonatal resuscitations and procedures and your airways all at once. I think the PD mentioned that they really start preparing interns for flight shifts, so you WILL get the sickest patients early in your EM career rather than being protected from them for the first year, which is pretty status quo for programs.

Chicago has (mandatory, I believe) flight time. When you are the R2, you fly during your shifts in the department as well as see patients. They also do fixed wing transport flights, which are a moonlighting opportunity (you get about 1000). The residents at Chicago are a VERY social bunch. The department sponsors a monthly social event (they get money from the fixed wing flights as well) for residents.

 

[mango6110]

So I really liked the program, but was hoping for some insight. Since there was not a pre-interview dinner, I did not get a good sense of the residents...are most single/married/kids? Do they hang out/good sense of camaraderie?

Thanks for the input!

 

[SeanCC]

So I really liked the program, but was hoping for some insight. Since there was not a pre-interview dinner, I did not get a good sense of the residents...are most single/married/kids? Do they hang out/good sense of camaraderie?

Thanks for the input!

U of Chicago might be the most unique program in the country. The flight opportunities alone would give you a ONCE in a lifetime experence. I know several of the residents there and I would say that most are single and they all get along pretty well. Dr. Howes hosts several events for them thoughout the year to help strenghten the camaraderie. The residents are a VERY diverse group (probably the most diverse group outside of the NYC programs) and they actually have active plans in place so that they might keep it that way. Its not perfect but U of C might be the sleeper pick for best program in the country...

 

[glorfindel]

I know the current second and third year classes, and I know some of the first years. I think they're *fantastic.*

They're smart, helpful, and witty. They hang out a lot. They have a sense of humor (whether it's compatible with yours is not something I can answer 🙂).

They're some of the best people I've been lucky enough to work with.

Good luck with your match.

 

[Tallerand]

I really liked my interview day there too(especially Dr. Howes), but i have some reservations about ranking Uchicago highly.
1. With the recent problems there, the PD at my home institution felt like it was a program that would take at least 5 years to get back to its former illustrious level.

2. With the addition of Evanston, I feel like the commute would be brutal cycling between the Uchicago, evanston, and lutheran. Seems like it would be at least a 45 minute drive each way because they are all on different sides of the city. I would imagine this could really affect quality of life

Can anyone comment on these

 

[Blake300m]

Hey all - I'm an intern at U of C and understand the reservations regarding a)not having a pre-interview social, b)the questions re the stability of the program and c)the issue with driving time.

With regards to A, initially when I was interviewing I was concerned that since the program does not have an pre-interview social, it might mean the residents aren't all that social. Definitely not true. Our intern class is very tight knit - each month the intern on anesthesia is given $300 to plan a social event - anything from drinking at a bar to whirlyball to going to eat at a restaurant to whatever we can think of. All three classes attend, as well as occasionally faculty members. We get along great with the 2nd and 3rd years and as cheesy/cliche it does seem like a big family. Someone mentioned how many are single/married etc? I would say for all 3 classes it's probably about half/half in terms of single or in relationship. The nice thing is that just about all the significant others are very well known to everyone in the program - there's been quite a few times that I've gone out with the husbands of my co-interns when they've been stuck working.

With regards to B, I honestly feel like our program is just about back to where it was before all the questions re the young boy that got bitten by a dog and the potential shutting down of 12 ER beds happened. Those ER beds are not going to be shut down, and that decision was finalized almost a year ago. Re the child that was bitten by the dog (unfortunatley I don't remember his name) and how he was allegedly not treated by UC, I feel that was mostly media hype - he was seen in the ER, wound washed out, given tetanus and abx, and a plastics consult was called, who ultimately felt that the wound would be better healed by secondary closure. Ultimately, I believe his mother took him to Cook County where his wound was closed that night. Regardless of which method was correct, the child was not simply told to leave and go to cook County, which was essentially how it was reported in the media and was what ACEP latched onto.
Dr. Howes was actually planning on retiring last year, but because of the questions that were raised about the program, he decided to stay on for another 3 years to try to ensure everyone of the program's stability - I think that says an amazing amount about how much he cares for the program and for the residents.

With regards to C, yeah, there's a bit of a commute. But you can live in an area of Chicago where the commute is not too bad. For instance, I live about 7 miles from UofC. It's about 20 minutes my front door to inside the ER to get to UC (even in rush hour, because LakeShore Drive going south almost never has traffic), and only 10-15 minutes to get to sinai (we do 1 month each 1st,2nd,3rd year at sinai). Now, to get to Evanston is longer, prob 40 min - however, we only do 2-2.5 months there as interns, and 1 month each 2nd and 3rd year. At Lutheran, which is in northwest, it's prob about a 25-30 min drive without traffic. With traffic it can indeed be as long as an hour, but there's not too many shifts we do where we are stuck driving in rush hour. Also, there's a free, nice gym in the hospital that we can go to, so you could always go early to miss rush hour and workout. We do about 2.5-3 months as interns at Lutheran, and about 3 months each 2nd and 3rd year.

Finally, and my plug for U of C - I really love it here. The patient pathology is amazing - at U of C it's never just headache, its headache and known HIV; 31 F with chest pain is 31 F with chest pain and known metastatic renal cell CA; 18 F with cough/fever is 18 F with cough/fever and known SLE. As interns, we do all the procedures in th ER - so if there's an intubation, a central line, or a Bartholin's cyst (had to throw in something not so glamorous), we'll be called to do it, even if it's not our patient or even if it's on the other side of the ER. We get a lot of ICU experience, with 1 month MICU, 3 weeks CCU, 3 weeks PICU, 5-7 call nights in the NICU (and all we do is procedures and go to high risk deliveries, no rounding on babies and no floor work), another month in the CCU, and then 2 months of trauma where we round in the SICUs (but don't carry the pts). We do no floor months (personally I love that but I know there was a thread recently debating the merits of floor months - honestly, during your trauma month you see how the floor works plenty well in my opinion). We fly, and when we fly it's us, the flight nurse, and the pilot - we're not just watching. I think having 4 sites is a great advantage during residency to get good exposure to different patient populations and different hospital settings - this lets you see what you want to be working in as an attending. Sure, you gotta drive more than a one site residency program, but it's a small price to pay in my opinion.

So, a bit lengthy, but I wanted to try to clear up any doubts and potentially answer any questions the current and future interviewees might have. Feel free to PM me if anybody has any particular questions.

 

[opb]

Overview: A 3 year "academic" program located near Chicago, Illinois. I say "academic" because it is affiliated with the University of Chicago, but due to its location you will be taking care of an urban/inner city patient population (in addition to complex medical cases due to UofC's reputation as a medical center). There are about 7 months of total ICU time (with the majority during your first year), 4 months of trauma experience, 1 month of tox selective, and 1 month of International EM/Elective. Flight time is mandatory during your second year. You will be rotating at four additional site throughout your training. There are 16 residents per year (starting last year).

Residents: There is no pre-interview social (which for me wasn't a big deal). You get to meet a lot of the residents during the interview day. All of the residents I met were very nice and friendly. All of them seemed happy with their choice. Also, all of them felt that all of the "issues" with the program (i.e. leadership changes, press regarding the ED diverting patients, etc.) were in the past and no longer an issue. The residents are from all over the country, and there is a good mix of singles and married/in relationships (varies from class to class). They all seemed to get along very well together.

Interview Day: Long day. I interviewed at Northshore/Evanston. The day started at 7:00am with some coffee and bagels/donuts. Next was a program overview given predominantly by some of the residents, with faculty adding things in from time to time. The PD showed up towards to end of the overview to give his talk regarding the program. Afterwards, we attended a portion of the conference. Interviews were with 3 faculty members and 2 chief residents, each about 20-30 minutes long. Although some of the interview questions were scripted (each interviewer asked certain required questions), there were no difficult or out-of-left-field questions, and the interviews ended up being conversational in nature. This was followed by a tour of the ED at Northshore and lunch with the residents. What made the day long was that if you did not interview with either the PD or associated PD, you had to stick around at the end until they talked with you. For instance, I interviewed with the associate PD (which was a great interview) but had to wait around at the end to talk with the PD. So, I ended up leaving at around 5:30pm. Long day.

Faculty: All of the faculty I met and interviewed with were great. I really liked the associate PD. She was energetic and easy to talk to. I also like the PD, who definitely is a character (but in a good way). He has been PD for 20 or so years and will be PD for the next 3-5 years. Residents reported a supportive environment where their suggestions are taken seriously.

Curriculum: 3 year program with heavy ICU experience in the first year and mandatory flight time during your second year. The specifics can be found on their website.

Some highlights:
- no medicine/surg/peds floor months
- one month of anesthesiology/NICU call
- one month toxicology selective during your second year
- one month International Health Care/Elective during your third year
- no call months after your second year
- flight experience during ED shifts second year

Peds experience seems pretty strong with 3 months dedicated peds ED time (one month per year Comer Children's Hospital, a Level I trauma center for peds). Also, I think adult and peds are integrated at most of your rotation sites, so you'll get continuous exposure to the kiddies. You also have some NICU and PICU experience thrown in.

Of note, UofC is a Level II trauma center, so your trauma experience will be gained at other hospitals (specifically Lutheran General and Mt. Sinai hospitals). Lutheran provides mostly blunt trauma while Mt. Sinai provides penetrating trauma experience.

EMS experience seems really strong here, due in large part to required flight experience. Basically, you are the Flight Physician during your ED months at UofC with the caveat being that you have to carry patients while you work in the department. So, these shifts could potentially be tough and would put your multi-tasking skills to the test. Also, it's probably tough for the seniors, too, because they are the ones carrying the patients while the R2 is flying. But, it's worked so far and the residents don't seem to mind. Another flight experience you have is transport of patients on fixed-wing aircraft. I don't know when you can do these (I think it's a moonlighting opportunity but possibly also during your EMS or Elective time). You get paid a pretty good stipend as well (I think about $1500).

International experience seems pretty good here, too, with one month available to you during third year. They have an established relationship with a hospital in Liberia, but other locations include Tanzania and India.

Didactics as per required 5 hours a week. Standard stuff with core lectures, simulation sessions, procedure labs, journal clubs, etc.

Shifts, courtesy of Peter Parker:
PGY1
19 ten-hour shifts at UCMC (3 months)
18 ten-hour shifts at Lutheran (1 month)
14 twelve-hour shifts at Evanston Hospital (1 month)
16 ten-hour shifts at Comer Children's (1 month)

The other months are Trauma (2 months) and ICU (4 months -- CCU, MICU, NICU/Anesthesia, PICU).

PGY2
12 eight-hour and 6 twelve-hour shifts at UCMC (5 months)
17 ten-hour shifts at Lutheran (2 months)
16 ten-hour shifts at Evanston Hospital (1 month)
14 twelve-hour shifts at Comer Children's (1 month)
14 twelve-hour shifts at Sinai Trauma Side (1 month)

The other 2 months are CCU and Toxicology.

PGY3
12 eight-hour and 6 twelve-hour shifts at UCMC (5 months)
17 ten-hour shifts at Lutheran (1 months)
16 ten-hour shifts at Evanston Hospital (1 month)
14 twelve-hour shifts at Comer Children's (1 month)
14 twelve-hour shifts at Sinai Trauma Side (1 month)

Facilities: I toured the ED at Northshore, which is a private hospital in Evanston, about 30 minutes north of downtown Chicago. The ED was on the smaller side with 20-30 beds. They see about 40,000 patients per year there. There is a pretty cool simulation center located here as well.

I didn't tour the ED at UofC, but I do know (along with everyone else) that it is a huge tertiary referral center. So you'll get your complex medical and transplant cases here. Also, due to its location in South Chicago, you'll get inner-city, underserved patients as well. The census is about 53,000 per year.

Lutheran General is a large private hospital located about 30 minutes northwest of downtown. You do some ED shifts here as well as trauma, which is predominantly blunt. Census here is about 55k.

Mt. Sinai is considered a community hospital, but due to it's location (southwest side of Chicago) will provide you with an underserved patient population and lots of penetrating trauma. Census here is about 55k.

Location: UofC itself is located in Hyde Park, a neighborhood on the south side of Chicago. Hyde Park itself is a pretty vibrant and integrated neighborhood, but the surrounding areas are places you would not (and should not) be walking around in at night. For my thoughts on Chicago, please see my Resurrection review. In short, huge city with big-city amenities, big-city traffic, big-city expenses, cold winters, but TONS of stuff to do.

opb's final thoughts: I think this is one of the strongest programs that I interviewed at. It's one of the oldest EM programs in the country, so that in itself hooks you up with nationwide connections and networks. I think that the curriculum is great if you want a lot of experience in critical care and EMS/flight. Also, given the number of sites you rotate at you will be seeing a very diverse patient population. Some things you might have to think about regarding this program are rotating at 5 total sites (diverse patient populations vs. commute time/learning new systems), mandatory (not optional) flight time, the home institution not being a Level I adult trauma center, and Chicago's cold (and long) winters.

 

[Pure Anergy]

Posted anonymously on behalf of a student who interviewed there.


University of Chicago Review

Pre-Interview Dinner: They don't have one. This is not new, and I had plenty of one-on-one time with residents on the interview day (morning session, lunch, tour, while waiting to speak with Dr. Howes at the end). Still, I must say that there's always something nice about grabbing drinks and/or food with residents the night before, seeing how many and who show up, etc etc. Dr. Howes mentioned that they don't do interview dinners in the interest of applicants' schedules and travel arrangements. Not a big deal, I think.

Interview Day: Starts early, ends late. Info session by a resident starts the morning off. Then we went to a critical care lecture given by one of the Pulm/CC docs - it was really well delivered and with some relevant questions asked by EM residents at the end. Then back for 5 interviews, including one with a third year resident. Interviews were relaxed, though several non-standard questions too. Lunch (sandwiches) was with residents - a lot of residents showed up and had uniformly good things to say about the program, the PD, and Chicago in general. Then tour of the UofC ED, which wasn't really busy when we were there. Of note, all applicants are asked to meet with both the PD (Dr. Howes) and the Asst. PD (Dr. Babcock) on interview day, but most are only scheduled to interview with one of the two. At the end of the day, you wait to speak to the other.

Curriculum: UofC EM is a three year program with three different yet extremely complimentary sites (and combined >160K pt visits). UofC is where you see your sick patients from the city - mostly indigent, AA, lots of unchecked chronic diseases, often coupled with HIV, etc. Mount Sinai is on the west side of town and is definitely the knife and gun club. Residents do both trauma and EM months here and speak highly of the training. I think a few other programs from Chicago also send their residents here for trauma. Finally, Northshore in Evanston is your more ritzy, suburban Level 1 trauma center where you have to tease out the sick patient from the bread and butter EM that typically rolls through. Northshore clearly has resources, an awesome simulation program, and generally nice facilities. Of note, UofC is not a level 1 trauma center, but the residents felt they saw more than enough trauma and level 1 notifications at the two other sites. And they're quick to mention that even though UofC is not a level 1 center, the population they cater to are incredibly sick. Speaking of, interns see and do it all. This seems to be a program that caters best to those that learn by doing and doing again, versus reading in a book or observing. Being comfortable with autonomy early on is almost a necessity at UofC since you're a designated flight doc as an EM2. You have to be willing to fly in a chopper. The patient transport stuff seems to be optional (more below). Finally, residents say the UofC Comer Children's Hospital is a fantastic place to care for sick kids. They are level 1, and I think also have residents from other programs rotating through. No floor months (no more waiting for the INR to reach target) and 5 (6?) ICU months, which is the most I have seen in a 3-year program. I really like critical care, so that's a ++ for me.

Benefits: Four weeks off each year (2 2-week blocks). $500/yr for whatever you want. Funding for conferences each year, plus medical-legal seminar second year. Paid expenses if you present at a conference. Obviously one of the biggest perks is the patient transport moonlighting that residents do (while on their easier months 2nd and 3rd years?). My understanding of it is that you are often repatriating patients who become sick while in the US or you are bringing sick patients to the US for medical care. Depending on the patient's needs, you either fly first class with the patient to their destination (with a code-bag in hand) or fly with them on a small jet that is essentially an ICU. $500/day to do this, you get to hang out in the cities you visit for a day, accomodations are taken care of, you keep the frequent flier miles. Residents I talked to had gone to Japan and Western Europe recently. In addition, EM3s get to do an all expense paid 1.5 month international elective if they choose. Or they can put together something on their own. Schedules are flexible according to Dr. Babacock.

Administration: The PD, Dr. Howes, by all accounts is a great person to work with and for. He has been doing this for a while and is well-known in EM circles. Dr. Babcock, the Asst. PD, is also extremely personable and energetic. She's doing a lot with the Global EM, specifically disaster management and relief. She and another faculty member were organizing members of the Chicago-wide response to the Haiti earthquake. For those interested in Global Health like me, the University of Chicago also has a cool interdisciplinary Global Health Inititiative that residents can take advantage of.

Chicago: So much to do, so much to see, so much to eat. I really needed to be in a real metropolitan city for residency, and I have to say Chicago wasn't high on my list before. But truthfully it has it all. Yes, it's really cold 4 months of the year. I guess that makes the other 8 months that much more lively.

Summary: Not a lot to dislike. It's a longstanding (second oldest?) EM program with a huge alumni network in both academic and private practice settings. It's very academic with significant research/scholarly activities. You reap the benefits of being on the campus of an awesome university - interdiscplinary work is fostered in settings like these. Yet it serves a population that really needs help and that reminds you of why you chose to be a doctor. High volume, you get to see different systems in very different neighborhoods with the 3 hospital system. You are exposed to everything from bread and butter EM, to penetrating trauma, to complicated quaternary-care referrals. Some potential drawbacks include that there aren't a ton of fellowships through UofC (but then again, fewer fellows means that residents do more). Didactics weren't touted, but everybody was satisfied with the didactics (again, it's more for those that learn by doing on day 1 rather than reading on day 1). You have to drive to the different hospitals - so maybe that's a negative. No orientation month, though you have a week of orientation in June. It's no secret that they had bad press a few years back. I spent a lot of time reading about this, and I (and my chairman at my med school) feel it was somewhat undeserved and quite slanted by the media. At any rate, the proposed changes to shut down ED beds, etc. never happened and won't happen with the new leadership. The kid that was mauled by the dog was NOT kicked out the door as reported by the media. Yes, UofC does struggle with wait times and is on diversion more than would be ideal. But this doesn't significantly affect our training as residents - UofC is definitely busy enough to always have patients for residents. And none of these "issues" are concerns at the other sites. And I'm told that a lot of this is expected to improve with the opening of a new building/facility (hospital?) for patient care in 2012. A few more positives. The residents were amazing - accomplished, nice, happy, and entertaining! The program gives them a budget each month to organize an event and it showed; they seemed to know each other really well and to enjoy being in each other's company. Of course, Chicago is great. Getting to make decisions in the field during a chopper run is an amazing learning and training opportunity.

Anyway, all told, I loved my day at UofC. This program was honestly not on my radar before I interviewed there and immediately shot up my list after the day. Like every other program out there, it's not for everybody. But I certainly would be ecstatic to train there!

 

[TrueBlueChi]

As someone who has graduated from this program within the past 3 years, I am in a unique position to give a review of this program. Overall, the program is in decline. In the past 5 years, they have lost 7 faculty members, 1 high quality teaching site, reduced the residency size by 1 resident per year and failed to publish a significant piece of clinical research. The residency is understaffed, financially struggling, and does not have the support of the medical center.

Faculty
The core faculty at UCMC has been shrinking for the past 5 years. The section has had unfilled openings for full time attendings for 5 years. In that time, 7 faculty members have left the institution and only 1 new member has been hired. They have lost their entire Toxicology program, Health Disparities program and all but one of their International Medicine faculty. There is only one fellowship trained faculty member in the entire section. The young faculty members with other prospects have left. Four members of their latest graduating class elected to become faculty members at other Chicago residencies rather than stay on at University of Chicago. The program is short on faculty and has not been able to recruit new faculty members.

Research
The program is technically considered an academic program; however, scholarship is not strong or established at this time and the majority of residents graduate without a publication or working on a publishable research project. The research centers in Emergency Resuscitation and Health Disparities have lost their leaders to other institutions and their projects have fallen apart. The section as whole has not conducted or published a meaningful piece of clinical research in a peer reviewed journal over 5-8 years and faculty members are seldom seen lecturing or presenting research at national EM conferences.

Residency Sites
The residency program lost one of their core sites (Lutheran General Hospital) and has replaced it with a lower volume, lower acuity site in NorthShore University Hospital – Evanston. Evanston’s patient population is primarily wealthy fast-track patients – insured, healthy, entitled and demanding. Learning opportunities at Evanston are fewer; there are fewer procedures, fewer sick patients and less evidence based management. The department is overstaffed with residents diluting any potential learning and attendings are reticent to allow any resident decision-making or management discussions. The site is a level I trauma center in name only. In spite of these concerns, residents are spending more time at this site every year due to financial issues with the program's budget.

Mount Sinai hospital in the underserved and violent west side of Chicago remains their best site; however, Mount Sinai has been unable to pay the program for their resident coverage for almost 2 years. Given the financial situation of the residency, it is unclear how long this relationship will be able to continue.

The University of Chicago Emergency room where residents do more than half of their training is not the site it once was. The acuity has dropped significantly over the past 5 years. Sick patients must typically survive 4-8 hours in the waiting room before ever seeing a doctor and truly sick patients end up leaving to go to other hospitals. The left without being seen rate is between 20-25% on any given month and residents average less than 1 patient per hour. The ER is also on ambulance diversion 40% of the time sending those sick patients with acute conditions to other area hospitals and depriving UC residents. The department boards approximately 50% of their beds at any given point. The ED at University of Chicago more closely resembles an inpatient floor than an emergency department most days.

Leadership
The single area where the program is lacking the most is in leadership. The program director is not well liked or supported by the ED faculty. He routinely leaves residents unsupervised for hours at a time while on shifts. With the addition of Evanston which contributes a large portion of the residency budget, he has lost control of the program. He is powerless and inept in advocating for the residents and the residency is run at the whim of Evanston’s leadership.

Flight Program
The lone bright spot in the University of Chicago Emergency Medicine residency is UCAN, the helicopter transport program. It still provides one of the best transport experiences in the Midwest. It, too, has fallen victim to hard times. Their volumes and transports are down and the program is no longer a mandatory part of the residency. Residents who are not interested in flying can opt out, leaving the burden of extra flights on the remaining residents who choose to fly.

Conclusion
The University of Chicago Emergency Medicine Residency is in a steep decline. They have lost their sites, faculty and residents. The leadership is weak and ineffective. The opportunities for learning are lacking. It will take at least 5-7 years for this program to recover. I would strongly advise competitive applicants to look elsewhere for the next several years.

 

[Hamhock]

As someone who has graduated from this program within the past 3 years, I am in a unique position

the majority of residents graduate without a publication or working on a publishable research project.

Disclaimer: I never interviewed, visited, or investigated the U of C residency program or hospital. That is, I have no informed opinion.

That said, I appreciate this poster's 'negative' review of the U of C program. Instead of just freely opining, the poster provide 'facts' to support views.

However, I am somewhat suspect of his 'facts' given that he (or she - settle down folks) states that the majority of residents don't work on a publishable research project.

Unless he is distinguishing between publishable "research" and publishable-quality academic work, he is implying the residency is in violation of RRC regs. Somehow, I doubt that was his intent; but I am interested if anyone can verify this? ...or do we assume his 'facts' are unsubstantiated.

I will leave the "As someone who graduated from this program within the last 3 years, I am in an unique position" section to Apollyon.

Still, I remain impressed that a negative review attempts to provide supporting evidence, instead of just spewing anger.

HH

 

[Arcan57]

Disclaimer: I never interviewed, visited, or investigated the U of C residency program or hospital. That is, I have no informed opinion.

That said, I appreciate this poster's 'negative' review of the U of C program. Instead of just freely opining, the poster provide 'facts' to support views.

However, I am somewhat suspect of his 'facts' given that he (or she - settle down folks) states that the majority of residents don't work on a publishable research project.

Unless he is distinguishing between publishable "research" and publishable-quality academic work, he is implying the residency is in violation of RRC regs. Somehow, I doubt that was his intent; but I am interested if anyone can verify this? ...or do we assume his 'facts' are unsubstantiated.

I will leave the "As someone who graduated from this program within the last 3 years, I am in an unique position" section to Apollyon.

Still, I remain impressed that a negative review attempts to provide supporting evidence, instead of just spewing anger.

HH

I don't think the RRC requires research specifically, just a "project". Even at Cinci, there were a number of residents whose project was not publishable research but a QI initiative.

 

[wreckloose2]

As someone who has graduated from this program within the past 3 years, I am in a unique position to give a review of this program. Overall, the program is in decline. In the past 5 years, they have lost 7 faculty members, 1 high quality teaching site, reduced the residency size by 1 resident per year and failed to publish a significant piece of clinical research. The residency is understaffed, financially struggling, and does not have the support of the medical center.

Faculty
The core faculty at UCMC has been shrinking for the past 5 years. The section has had unfilled openings for full time attendings for 5 years. In that time, 7 faculty members have left the institution and only 1 new member has been hired. They have lost their entire Toxicology program, Health Disparities program and all but one of their International Medicine faculty. There is only one fellowship trained faculty member in the entire section. The young faculty members with other prospects have left. Four members of their latest graduating class elected to become faculty members at other Chicago residencies rather than stay on at University of Chicago. The program is short on faculty and has not been able to recruit new faculty members.

Research
The program is technically considered an academic program; however, scholarship is not strong or established at this time and the majority of residents graduate without a publication or working on a publishable research project. The research centers in Emergency Resuscitation and Health Disparities have lost their leaders to other institutions and their projects have fallen apart. The section as whole has not conducted or published a meaningful piece of clinical research in a peer reviewed journal over 5-8 years and faculty members are seldom seen lecturing or presenting research at national EM conferences.

Residency Sites
The residency program lost one of their core sites (Lutheran General Hospital) and has replaced it with a lower volume, lower acuity site in NorthShore University Hospital – Evanston. Evanston’s patient population is primarily wealthy fast-track patients – insured, healthy, entitled and demanding. Learning opportunities at Evanston are fewer; there are fewer procedures, fewer sick patients and less evidence based management. The department is overstaffed with residents diluting any potential learning and attendings are reticent to allow any resident decision-making or management discussions. The site is a level I trauma center in name only. In spite of these concerns, residents are spending more time at this site every year due to financial issues with the program's budget.

Mount Sinai hospital in the underserved and violent west side of Chicago remains their best site; however, Mount Sinai has been unable to pay the program for their resident coverage for almost 2 years. Given the financial situation of the residency, it is unclear how long this relationship will be able to continue.

The University of Chicago Emergency room where residents do more than half of their training is not the site it once was. The acuity has dropped significantly over the past 5 years. Sick patients must typically survive 4-8 hours in the waiting room before ever seeing a doctor and truly sick patients end up leaving to go to other hospitals. The left without being seen rate is between 20-25% on any given month and residents average less than 1 patient per hour. The ER is also on ambulance diversion 40% of the time sending those sick patients with acute conditions to other area hospitals and depriving UC residents. The department boards approximately 50% of their beds at any given point. The ED at University of Chicago more closely resembles an inpatient floor than an emergency department most days.

Leadership
The single area where the program is lacking the most is in leadership. The program director is not well liked or supported by the ED faculty. He routinely leaves residents unsupervised for hours at a time while on shifts. With the addition of Evanston which contributes a large portion of the residency budget, he has lost control of the program. He is powerless and inept in advocating for the residents and the residency is run at the whim of Evanston’s leadership.

Flight Program
The lone bright spot in the University of Chicago Emergency Medicine residency is UCAN, the helicopter transport program. It still provides one of the best transport experiences in the Midwest. It, too, has fallen victim to hard times. Their volumes and transports are down and the program is no longer a mandatory part of the residency. Residents who are not interested in flying can opt out, leaving the burden of extra flights on the remaining residents who choose to fly.

Conclusion
The University of Chicago Emergency Medicine Residency is in a steep decline. They have lost their sites, faculty and residents. The leadership is weak and ineffective. The opportunities for learning are lacking. It will take at least 5-7 years for this program to recover. I would strongly advise competitive applicants to look elsewhere for the next several years.

I'm not going to write nearly as detailed a message as this but as someone who also recently graduated from this program I felt the need to respond. The main problem I have with this post is that it's manipulative and agenda driven. There are truths, half truths and outright lies about the program all mixed together to keep potential applicants away. I'm not going to make excuses or lie about the program which is far from perfect. However, I received outstanding training in spite of the issues because the population that frequents the University of Chicago and Mt.Sinai are just plain sick. By the end of my first year not only was I zipping through putting in central lines and intubating people but could deal with an ESRD/CHF exacerbation without batting an eye.

So just to clarify, the program has added new faculty (3 that I'm aware of) over the past year including a recent graduate. The leader of their health disparities program left for 1 year to participate in a White House Fellowship and has since returned as faculty. There is absolutely no plan to change our relationship with Mt.Sinai. As stated, the acuity level of our patients is high and it was only on slow nights that I saw 1 patient or less an hour. My average was more like 2 overall and when I was the senior on either end of the ER it was more like 2-3. And to say that flying is optional is absolutely ridiculous. Many a 2nd year resident being interrupted in the middle of a procedure or treating an ill patient to go an a transport has wished that it were optional but alas, that is far from the truth. It is a requirement of the residency that all 2nd year residents while working in the University of Chicago ER go on all flights and 3rd year residents go on some. Though I don't have statistics on flight volume or patient acuity, when I was a 2nd year I went on a transport at least once every other shift and this was what I saw when I was in my 3rd year losing my 2nd year resident.

Those were the most glaring misrepresentations that I wanted to point out. As I said, our program is not perfect but I don't want people forming an opinion of this program based on lies from someone with an agenda. I'd rather base my opinion on facts good or bad.

 

[silverpaw54]

I am interested in the program. Any other people interview there, currently training, or graduated from the program willing to chime in their opinion?

Thank you!

 

[chimppp]

absolutely! current resident, love our program, and am happy to answer any questions.

 

[RxnMan]

Posted for a applicant who wishes to remain anonymous:

University of Chicago Review

Pre-Interview Dinner: They don't have one. This is not new, and I had ample one-on-one time with residents on the interview day (morning session, lunch, tour, while waiting to speak with Dr. Howes at the end). Still, I must say that there's always something nice about grabbing drinks and/or food with residents the night before, seeing how many and who show up, etc etc. Dr. Howes mentioned that they don't do interview dinners in the interest of applicants' schedules and travel arrangements. Not a big deal, I think.

Interview Day: Starts early, ends late. Info session by a resident starts the morning off. Then we went to a critical care lecture given by one of the Pulm/CC docs - it was really well delivered and with some relevant questions asked by EM residents at the end. Then back for 5 interviews, including one with a third year resident. Interviews were relaxed, though several non-standard questions too. Lunch (sandwiches) was with residents - a lot of residents showed up and had uniformly good things to say about the program, the PD, and Chicago in general. Then tour of the UofC ED, which wasn't really busy when we were there. Of note, all applicants are asked to meet with both the PD (Dr. Howes) and the Asst. PD (Dr. Babcock) on interview day, but most are only scheduled to interview with one of the two. At the end of the day, you wait to speak to the other.

Curriculum: UofC EM is a three year program with three different yet extremely complimentary sites (and combined >160K pt visits). UofC is where you see your sick patients from the city - mostly indigent, AA, lots of unchecked chronic diseases, often coupled with HIV, etc. Mount Sinai is on the west side of town and is definitely the knife and gun club. Residents do both trauma and EM months here and speak highly of the training. I think a few other programs from Chicago also send their residents here for trauma. Finally, Northshore in Evanston is your more ritzy, suburban Level 1 trauma center where you have to tease out the sick patient from the bread and butter EM that typically rolls through. Northshore clearly has resources, an awesome simulation program, and generally nice facilities. Of note, UofC is not a level 1 trauma center, but the residents felt they saw more than enough trauma and level 1 notifications at the two other sites. And they're quick to mention that even though UofC is not a level 1 center, the population they cater to are incredibly sick. Speaking of, interns see and do it all. This seems to be a program that caters best to those that learn by doing and doing again, versus reading in a book or observing. Being comfortable with autonomy early on is almost a necessity at UofC since you're a designated flight doc as an EM2. You have to be willing to fly in a chopper. The patient transport stuff seems to be optional (more below). Finally, residents say the UofC Comer Children's Hospital is a fantastic place to care for sick kids. They are level 1, and I think also have residents from other programs rotating through. No floor months (no more waiting for the INR to reach target) and 5 (6?) ICU months, which is the most I have seen in a 3-year program. I really like critical care, so that's a ++ for me.

Benefits: Four weeks off each year (2 2-week blocks). $500/yr for whatever you want. Funding for conferences each year, plus medical-legal seminar second year. Paid expenses if you present at a conference. Obviously one of the biggest perks is the patient transport moonlighting that residents do (while on their easier months 2nd and 3rd years?). My understanding of it is that you are often repatriating patients who become sick while in the US or you are bringing sick patients to the US for medical care. Depending on the patient's needs, you either fly first class with the patient to their destination (with a code-bag in hand) or fly with them on a small jet that is essentially an ICU. $500/day to do this, you get to hang out in the cities you visit for a day, accomodations are taken care of, you keep the frequent flier miles. Residents I talked to had gone to Japan and Western Europe recently. In addition, EM3s get to do an all expense paid 1.5 month international elective if they choose. Or they can put together something on their own. Schedules are flexible according to Dr. Babacock.

Administration: The PD, Dr. Howes, by all accounts is a great person to work with and for. He has been doing this for a while and is well-known in EM circles. Dr. Babcock, the Asst. PD, is also extremely personable and energetic. She's doing a lot with the Global EM, specifically disaster management and relief. She and another faculty member were organizing members of the Chicago-wide response to the Haiti earthquake. For those interested in Global Health like me, the University of Chicago also has a cool interdisciplinary Global Health Inititiative that residents can take advantage of.

Chicago: So much to do, so much to see, so much to eat. I really needed to be in a real metropolitan city for residency, and I have to say Chicago wasn't high on my list before. But truthfully it has it all. Yes, it's really cold 4 months of the year. I guess that makes the other 8 months that much more lively.

Summary: Not a lot to dislike. It's a longstanding (second oldest?) EM program with a huge alumni network in both academic and private practice settings. It's very academic with significant research/scholarly activities. You reap the benefits of being on the campus of an awesome university - interdiscplinary work is fostered in settings like these. Yet it serves a population that really needs help and that reminds you of why you chose to be a doctor. High volume, you get to see different systems in very different neighborhoods with the 3 hospital system. You are exposed to everything from bread and butter EM, to penetrating trauma, to complicated quaternary-care referrals. Some potential drawbacks include that there aren't a ton of fellowships through UofC (but then again, fewer fellows means that residents do more). Didactics weren't touted, but everybody was satisfied with the didactics (again, it's more for those that learn by doing on day 1 rather than reading on day 1). You have to drive to the different hospitals - so maybe that's a negative. No orientation month, though you have a week of orientation in June. It's no secret that they had bad press a few years back. I spent a lot of time reading about this, and I (and my chairman at my med school) feel it was somewhat undeserved and quite slanted by the media. At any rate, the proposed changes to shut down ED beds, etc. never happened and won't happen with the new leadership. The kid that was mauled by the dog was NOT kicked out the door as reported by the media. Yes, UofC does struggle with wait times and is on diversion more than would be ideal. But this doesn't significantly affect our training as residents - UofC is definitely busy enough to always have patients for residents. And none of these "issues" are concerns at the other sites. And I'm told that a lot of this is expected to improve with the opening of a the new hospital pavilion (240 new beds) in late 2012. A few more positives. The residents were amazing - accomplished, nice, happy, and entertaining! The program gives them a budget each month to organize a social event and it showed; they seemed to know each other really well and to enjoy being in each other's company. Residents were diverse - geographically, racially, philosophically. Of course, Chicago is great. Getting to make decisions in the field during a chopper run is an amazing learning and training opportunity.

Anyway, all told, I really loved my day at UofC. This program was honestly not significantly on my radar before I interviewed there - I was more interested in other Chicago programs - and it immediately shot up my list after the interview day. Like every other program out there, it's not for everybody. But certainly I loved it and would be ecstatic to train there!

 

[oyoyoy]

The news says University of Chicago is opening a level I trauma unit in early 2018. Can someone from the program confirm the time line? And does anyone know how this will affect training? www.chicagotribune.com/news/ct-university-of-chicago-trauma-center-hyde-park-campus-20151217-story,amp.html

 

[rbnsafsadgf]

The new ED, which will include facilities for trauma, is under construction at this time. They are hiring EM and trauma faculty now. Plans are to open the new ED around Dec 2017 and then the trauma center a few months after that in early 2018. It is projected to be the busiest trauma center in Chicago due to its south side location.

 

[Hereiam888]

• Any residents willing to give an updated review of their experience thus far?

 

[emedhopeful432]

• Any residents willing to give an updated review of their experience thus far?

• What are the average number and length of shifts (in hours) per month for each year? Is there enough time to pursue academic/professional /extracurricular interests
• What is the pediatric experience like? Longitudinal exposure with shifts every ED block or designated Peds ED blocks only?
• Are there any emergency procedures that EM residents are not allowed to do(RSI, thoracotomies)?
• Are shifts stratified by acuity (e.g., “trauma” shift or “resuscitative” shift), or is the entire spectrum of pathology/trauma seen on each shift?

 

[HollaAtMe]

• What are the average number and length of shifts (in hours) per month for each year? Is there enough time to pursue academic/professional /extracurricular interests
• What is the pediatric experience like? Longitudinal exposure with shifts every ED block or designated Peds ED blocks only?
• Are there any emergency procedures that EM residents are not allowed to do(RSI, thoracotomies)?
• Are shifts stratified by acuity (e.g., “trauma” shift or “resuscitative” shift), or is the entire spectrum of pathology/trauma seen on each shift?

I remember scouring these threads last year looking for more info so I'll try to update this with what I can.

In general, so far the experience has lived up to what I expected. I came here for a bunch of reasons, but primarily because I felt that this program has a nice balance of academic strength/resources and a mission to serve an underserved population. Also Chicago is awesome. From the academic side, I haven't fully explored most options since I've mostly been trying to learn clinical stuff, but it seems like there are plenty of research opportunities. We seem to have a young and energetic group of faculty that are pretty active in their academic work or already established in some niche. I also think that the teaching here has been very good in the ED, and on off service rotations (esp ICU ones), the learning has been amazing. The pt population I think is pretty unique. There are a lot of underserved patients who seek care here, but there are also the well-insured LVAD and transplant patients who present as well; the range of pathologies you can see in a shift at the university is impressive.

To answer the Qs above:

-Shifts are probably 17-18/month. At the university hospital they are 8hrs with 12s on Fri-Sun. We work one weekend (Fri-Sat-Sun) all 12s and take the next Fri-Sun off. Makes for a tough weekend but worth it I think. At the community hospital the shifts are all 10s. When you're a senior and working at the county hospital, shifts are all 12s (I think).

-Peds is in blocks at our children's hospital; seems to be a good site with interesting pathology. When you're a senior you run traumas there too (it's a peds level 1 trauma center).

-I can't think of a procedure we don't do at the university.

-Shifts are shifts, with the exception of the teaching resident who is a senior that spends a shift teaching, doing procedures, and awaiting flights/transports. As interns our trauma experience is as part of the trauma surgery team at the county hospital, so I guess that's kind of like pure trauma work. As seniors you work in the county ED seeing a mix of trauma and medical. A lot will probably change as we become a level 1 trauma center though.

p.s. excuse my username, I made this account when I was dumb

 

[GoodDoggy]

I remember scouring these threads last year looking for more info so I'll try to update this with what I can.

In general, so far the experience has lived up to what I expected. I came here for a bunch of reasons, but primarily because I felt that this program has a nice balance of academic strength/resources and a mission to serve an underserved population. Also Chicago is awesome. From the academic side, I haven't fully explored most options since I've mostly been trying to learn clinical stuff, but it seems like there are plenty of research opportunities. We seem to have a young and energetic group of faculty that are pretty active in their academic work or already established in some niche. I also think that the teaching here has been very good in the ED, and on off service rotations (esp ICU ones), the learning has been amazing. The pt population I think is pretty unique. There are a lot of underserved patients who seek care here, but there are also the well-insured LVAD and transplant patients who present as well; the range of pathologies you can see in a shift at the university is impressive.

To answer the Qs above:

-Shifts are probably 17-18/month. At the university hospital they are 8hrs with 12s on Fri-Sun. We work one weekend (Fri-Sat-Sun) all 12s and take the next Fri-Sun off. Makes for a tough weekend but worth it I think. At the community hospital the shifts are all 10s. When you're a senior and working at the county hospital, shifts are all 12s (I think).

-Peds is in blocks at our children's hospital; seems to be a good site with interesting pathology. When you're a senior you run traumas there too (it's a peds level 1 trauma center).

-I can't think of a procedure we don't do at the university.

-Shifts are shifts, with the exception of the teaching resident who is a senior that spends a shift teaching, doing procedures, and awaiting flights/transports. As interns our trauma experience is as part of the trauma surgery team at the county hospital, so I guess that's kind of like pure trauma work. As seniors you work in the county ED seeing a mix of trauma and medical. A lot will probably change as we become a level 1 trauma center though.

p.s. excuse my username, I made this account when I was dumb

Thanks for the information.

Does anyone have updates on the new ED/Trauma center? Will this change the number of shifts/schedule drastically? How are the traumas run (ie surgery v anesthesia v EM roles)?

Interested in any updated/general information residents are willing to offer. How are your off service rotations? I have tried to find the curriculum breakdown on the site, but failed. How is cost of living? Do you have to commute far to live reasonably? Thanks!

 

[rbnsafsadgf]

• What are the average number and length of shifts (in hours) per month for each year? Is there enough time to pursue academic/professional /extracurricular interests

Mostly 8-9 hrs shifts, weekend 12’s (so that we can get three day weekends).
Total hrs 50-60 hrs per week in the ED, usually closer to 50; 70-80 hrs/wk off service (only 6 months intern year).

• What is the pediatric experience like? Longitudinal exposure with shifts every ED block or designated Peds ED blocks only?

As in the previous post, 1 month of dedicated PEM each year, 1 month of PICU intern year. Peds experience longitudinal at Northshore (community, kids sprinkled in) and through UCAN transports (sometimes very sick infants to teens where we are doing critical care transport).

• Are there any emergency procedures that EM residents are not allowed to do(RSI, thoracotomies)?

We do all procedures. Details of trauma bay work sharing TBD but I am not worried about it. We are projected to the busiest trauma center in Chicago, with about 50% penetrating trauma by my guess and previous south side experience.

• Are shifts stratified by acuity (e.g., “trauma” shift or “resuscitative” shift), or is the entire spectrum of pathology/trauma seen on each shift?

Right now there is no split by acuity. I expect that the new staffing will be the same way with the exception of a few triage shifts for seniors.

• Does anyone have updates on the new ED/Trauma center? Will this change the number of shifts/schedule drastically? How are the traumas run (ie surgery v anesthesia v EM roles)?

New ED opening this Dec, trauma center designation to follow in a few months.
We are going to be setting the culture on how traumas are going to be run. ED senior head of head, trauma team (including EM interns) will be there as well. No plans to have anesthesia involved in routine trauma. Our PD has our back.


• Interested in any updated/general information residents are willing to offer. How are your off service rotations? I have tried to find the curriculum breakdown on the site, but failed. How is cost of living? Do you have to commute far to live reasonably? Thanks!


The curriculum is still available at: First Year: EM1 | The University of Chicago: Emergency Medicine Residency . Off service: MICU is great. PICU is good, as limited by typical protective nature of the unit. CCU is good, but you work hard. Curriculum will be slightly changed this upcoming year. Trauma will now be done at UC.

With the change of trauma to UC, all but two months of the year will be at UC. So if you live in Hyde Park you can walk or bike for all but two months. For those two months, Northshore sites are 30 to 60 mins drive away, sometimes with additional traffic. Some people live in Hyde Park, a good portion in the South Loop and some scattered up north and west in the more popular neighborhoods. Cost of living is overall very good in Chicago and you get paid relatively well. UC’s resident health insurance is very good and you pay very little for it. Gym membership is also cheap at UC. We have some built in moonlighting PGY2-3 for those interested as well.

 

[BenignBeignet]

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

University of Chicago: 3 year program in underserved south Chicago. Historic program. High volume, high acuity, high autonomy. Strong ortho program = less ortho reductions for EM unless on ortho rotation or community site. Trauma, EM get all airways, intern assists with procedures and FAST (split between EM and surgery?). Strong ultrasound program, working on getting TEE in ED. HUGE emphasis on social EM and serving their community, Dr. Pratt is doing INCREDIBLE things for his community. Community site is over 45 minutes away. Can do research if motivated but can be tough to find (be more of a self-starter). No EM-CCM faculty, not many people match CCM past years but current resident pursuing CCM and has plenty of support from program leadership. Moonlight as PGY2.