Are their any EM programs you've been warned about?

[GrnLt]

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Hey everyone,

Just wondering about any EM programs that you've heard bad things about. (ie. unhappy residents, probation problems, warned by your program director or EM advisors) Let's get this rolling as we all make our lists.

 

[Apollyon]

One thing I told applicants was be wary of any program where you saw few or no residents - either they were too busy to meet applicants, didn't want to, or were kept away by facutly/program director, but all are warning signs.

 

[12R34Y]

One thing I told applicants was be wary of any program where you saw few or no residents - either they were too busy to meet applicants, didn't want to, or were kept away by facutly/program director, but all are warning signs.

That's typically what i had heard as well, but now I'm not so sure.

There were a few very well-known nice, great programs that had horrible turnouts at the resident dinner the night before and at lunch during the day.

It shocked me and i wasn't happy with it, but a billion people on the board are ranking highly etc...


so, i think you just have to realize that sometimes they'll be low-turnout.

later

 

[mikecwru]

One thing I told applicants was be wary of any program where you saw few or no residents - either they were too busy to meet applicants, didn't want to, or were kept away by facutly/program director, but all are warning signs.

Maybe if a program has a reputation of doing that. We had one dinner right after we started interviewing again after the holidays. No one really showed because everyone thought the dinners started up again NEXT week. It wasn't because the program was fundamentally flawed.

My only piece of advice: ask questions to make sure the part that's being sold to you is true or at least how you're envisioning it. I think I've repeated this to every applicant I've met, or interviewed.

mike

 

[EctopicFetus]

On my Transitional interview the PD told me one thing, I talked to the residents and they basically told me the exact opposite!.. This DID NOT happen in my EM interviews though. The residents do give a good perspective though!

 

[GeneralVeers]

One thing I told applicants was be wary of any program where you saw few or no residents - either they were too busy to meet applicants, didn't want to, or were kept away by facutly/program director, but all are warning signs.

Not necessarily a universal warning sign. While interviewing at Indiana last year (considered one of the top Midwest programs) they didn't have a resident dinner at all, had no residents meet us for lunch, and only had 2-3 give us a quick tour of the hospital.

 

[Apollyon]

Not necessarily a universal warning sign. While interviewing at Indiana last year (considered one of the top Midwest programs) they didn't have a resident dinner at all, had no residents meet us for lunch, and only had 2-3 give us a quick tour of the hospital.

But that's just it - reputation carries places by the word of mouth of students/applicants; there are several programs that come to mind that aren't as hallowed as the students believe them to be, and all I'm saying is that you should ask where the other residents are. Programs may be recruiting the workaholics, so it doesn't click with the current residents that the applicants might not be aware of this.

 

[waterski232002]

Honestly... who cares about the resident turnout. There could be tons of reasons why turnout wasn't so hot (interns on off services, upper levels interviewing for jobs, people working the night shifts, residents actually having lives OUTSIDE of medicine).

Just make sure that you talk to at least 2 or 3 residents at some time during your interview trip or second look, and tease out of them just how hard they work. Also, try to really see if they look tired, worn-out, or depressed. At 2 programs I interviewed at there was great resident turn out, but they all looked like they had been beat down with hockey sticks. I mean, they really looked unhappy and depressed (you could see it in their glossed over eyes)... and when I asked them how hard they worked, they just kept saying, "we work REALLY hard". I'm not lazy by any means, but this was a big warning sign to me. Residents will typically be very honest about their work load.

 

[OSUdoc08]

Hey everyone,

Just wondering about any EM programs that you've heard bad things about. (ie. unhappy residents, probation problems, warned by your program director or EM advisors) Let's get this rolling as we all make our lists.

ACGME: Drew (Los Angeles, CA) --> Based off of numerous posts on SDN & news articles about the hospital itself

AOA: Tulsa Regional (Tulsa, OK) --> Probation problems & highly unstable program (per current residents)

 

[DrMom]

There is a change in attendings at the TRMC program, but that doesn't make it unstable. I have no idea what residents you've been talking to. The probation issue is short-term and relates to a single paperwork deficiency, nothing academic. The hospital issues will be dealt with within a few months per our dean, btw.

 

[GeneralVeers]

ACGME: Drew (Los Angeles, CA) --> Based off of numerous posts on SDN & news articles about the hospital itself

AOA: Tulsa Regional (Tulsa, OK) --> Probation problems & highly unstable program (per current residents)

The issues with Drew are more related to the hospital. Should the hospital get re-accredited next month, the program will continue to exist. The program itself doesn't have issues with ACGME, or RRC.

If the hospital closes there are going to be 36 EM residents in need of a new home.

 

[edinOH]

AOA: Tulsa Regional (Tulsa, OK) --> Probation problems & highly unstable program (per current residents)

I've heard bad things for years about the Tulsa program. Not really sure what to make of those things since they are still around.

I've also heard that the place to be for osteopathic training in OK is the OKC program. I've heard they are solid and train strong residents.

I guess I'll see first hand come July.

 

[OSUdoc08]

I've heard bad things for years about the Tulsa program. Not really sure what to make of those things since they are still around.

I've also heard that the place to be for osteopathic training in OK is the OKC program. I've heard they are solid and train strong residents.

I guess I'll see first hand come July.

I've heard nothing but positives here. I agree.

 

[kungfufishing]

I'd third the positive OKC hearsay.
TRMC has some quality teaching attendings and has produced good EPs, but is in the midst of tumultuous times. The new well regarded program down the road in OKC probably hasnt helped in terms of recruitment, either.

 

[bartleby]

Honestly... who cares about the resident turnout./QUOTE]

Who should care about the resident turnout? Let's see... the applicants, because there's no better way for a disgruntled group of residents who are either so unhappy in their program or disillusioned that they are looking to give an F.U. to their PD/faculty or are unconsciously trying to warm unsuspecting applicants away. The current residents should care, as applicants are their prospective future co-workers, and failing to do their part means they increase their odds of working with a bunch of stiffs next year. If you care about your program at all, staying an extra 45 minutes for a free lunch after your sign out post call is not much of an imposition. The PD should care because nothing makes their residents look unhappy like a bunch of absent residents.

The resident in my program were very happy, and the turnout at night before meet-and-greets and lunchtime & tours was always very good.

Sparsely attended resident functions should not be considered the mark of death, but should be considered a warning sign for sure.

 

[bartleby]

0

 

[waterski232002]

Who should care about the resident turnout? Let's see... the applicants, because there's no better way for a disgruntled group of residents who are either so unhappy in their program or disillusioned that they are looking to give an F.U. to their PD/faculty or are unconsciously trying to warm unsuspecting applicants away. The current residents should care, as applicants are their prospective future co-workers, and failing to do their part means they increase their odds of working with a bunch of stiffs next year. If you care about your program at all, staying an extra 45 minutes for a free lunch after your sign out post call is not much of an imposition. The PD should care because nothing makes their residents look unhappy like a bunch of absent residents.

The resident in my program were very happy, and the turnout at night before meet-and-greets and lunchtime & tours was always very good.

Sparsely attended resident functions should not be considered the mark of death, but should be considered a warning sign for sure.

Once again... if you actually TALK TO THE RESIDENTS that you do see, it shouldn't make a difference how many show. Having a normal conversation with an honest resident will tell you a lot more than counting heads and a free lunch. That's why we actually TALK TO PATIENTS instead of making decisions based on cheif complaints and vitals.

 

[The White Coat Investor]

Not necessarily a universal warning sign. While interviewing at Indiana last year (considered one of the top Midwest programs) they didn't have a resident dinner at all, had no residents meet us for lunch, and only had 2-3 give us a quick tour of the hospital.

And THAT was why I didn't go to Indiana.

 

[corpsmanUP]

Not necessarily a universal warning sign. While interviewing at Indiana last year (considered one of the top Midwest programs) they didn't have a resident dinner at all, had no residents meet us for lunch, and only had 2-3 give us a quick tour of the hospital.

For what its worth, most of my top ranked programs did a dinner the evening before, and all had a good resident turnout. You really have to appreciate these dinners because more times than not, many of the residents came before or after a shift and were able to put on a smile and speak highly of their program. I know I plan to do the same when I am a resident. Its like selling your house.

And I think trying to base the feel of a residency on a brief interaction with 1-2 residents is not wise. I think you need a room full of residents mostly to see how they interact with each other, and the applicants. Only a few places I have been had an issue showing residents to the applicants. But more time than not, it was my fellow applicants that failed to take advantage of the dinners or get-togethers and I found myself the only applicant or 1 of 2 or 3 with a group of residents.

 

[colforbinMD]

This brings up a great question. What was the SADDEST resident dinner you attended. For me it was 2 interviewees and 2 residents plus one residents wife and child.
Keep in mind by saddest I simply am referring to turnout. The dinner and conversations that evening were fine. Though there was an odd 15 minutes where they complained about different stuff to one another as if the other applicant and I were not there.

 

[missdr]

at BW/MG there were 2 days of interviewees (like 20 or 25!) and 3 or 4 residents...and the one resident that i talked to said he had been paged like 3 times that day about the dinner and asking him to go...there was a good turn out at the lunch, but it was still sort of a turn off to have so few residents show up for the dinner!!!

 

[colforbinMD]

at BW/MG there were 2 days of interviewees (like 20 or 25!)

YIKES I don't think ANY of my dinners made it to double digit interviewees numbers. Of course I never went to one that was 2 days worth either.

 

[Koko]

This brings up a great question. What was the SADDEST resident dinner you attended. For me it was 2 interviewees and 2 residents plus one residents wife and child.
Keep in mind by saddest I simply am referring to turnout.

The saddest, hands down: one of 3 "EM interns" who represented VCU at the dinner and spent the whole night talking about the program and answering questions, including "what do you think you'd like to do after you're done?", turned out to be someone who had already completed all the paperwork to switch to anesthesiology. That's plain wrong and sealed the deal on that place. 👎

 

[TysonCook]

At an unnamed program that I interviewed at I was the only interviewee that showed up. It was basically me and 8 residents....kinda wierd. I felt bad that I was keeping them all, so I only ordered a appy and then let them get home 🙂

 

[corpsmanUP]

I don't know if I really have a "saddest", but I definitely had some "best" ones.

LSU-Baton Rouge: best dinner by far with tons of residents, faculty, PD, and it was at the PC's house where she cooked the most incredible meal. The house was gorgeous and was down the road toward LSU main. Those people know how to throw a party!

Runner up- U Pitt. "The Church" is a fabulous restaurant/pub with some of the best pizza and beer, and the UPitt guys are close behind the LSU guys in terms of knowing how to drown sorrows!

Runner up- Case/Metrohealth- another group who knows how to hang out and have a good time. Great beer, great pizza, and the people were what made it. No one sitting around complaining, and everyone got along very well. Lots of residents.

Iowa, OSU, Mayo, Peoria, and Scott and White also had great dinners that get them a very strong honorable mention, and anyone who has met FoughtFyre at a Mayo dinner can attest to how easily he breaks the ice for a four star grade on atmosphere!!

Tipping the scale toward average dinners we have Penn State (only 2 residents and my wife and kids..but toward the end of the season), Duke mostly because a lack of social skills on the part of some of the residents that night (but their lunch the next day had different residents...much more social).

Christ, Texas Tech, and Geisinger had no official get-togethers the day before but it had no affect on how much I liked them at all. Had I not had adequate exposure to their residents then I might have cared.

 

[GeneralVeers]

Best:

Beaumont, MI - Great meal at Buca's, 10 applicants, 8 residents and tons of liquor.

Wash U - Dinner at a pizza place, 8 applicants, 10+ residents. Cool dinner overall. (no liquor though)

Worst:

Jacksonville Fl - lunch on interview day at the Adam's Mark with a "limited selection". 10 interviewees, 1 second year resident.

Indiana (for reasons mentioned).


I'm trying to get our new PD to start up pre-interview dinners, since our old PD never endorsed that. Me and one of my fellow interns took some interviewees out this year to dinner at our own cost.

 

[WTF?]

Although the University of Cincinnati has an excellent program, I personally know a resident there who really dislikes it and was considerering switching to a different program. I never got the exact details as to why, and haven't recently talked to them but that was a big warning sign considering how much I respect the resident.

 

[11-44]

Veers. They ought to make you the PD!

 

[JackBauERfan]

Veers. They ought to make you the PD!

I agree, Veers for El Presidente!!!

 

[southerndoc]

Although the University of Cincinnati has an excellent program, I personally know a resident there who really dislikes it and was considerering switching to a different program. I never got the exact details as to why, and haven't recently talked to them but that was a big warning sign considering how much I respect the resident.

One resident leaving in what, 10 years? I think Cincinnati hasn't had many residents leaving. So that makes it seem more like individual preferences and not about the program itself.

I've heard all good things about Cincinnati.

 

[EctopicFetus]

Ditto on Cincy.. one in 10 years doesnt mean much..

 

[Taintwax]

I am in complete agreement that Cincinnati is an exceptional program, although certainly not the right program for everyone. There appears to be a very demanding work load, especially as an intern. I don't know the details, but, as I was informed, there have been two residents leave in the past three years. None of the other programs I am ranking have had any residents leave. I still don't think that this warrants issuing a 'warning' about Cincinnati.

 

[southerndoc]

I am in complete agreement that Cincinnati is an exceptional program, although certainly not the right program for everyone. There appears to be a very demanding work load, especially as an intern. I don't know the details, but, as I was informed, there have been two residents leave in the past three years. None of the other programs I am ranking have had any residents leave. I still don't think that this warrants issuing a 'warning' about Cincinnati.

That's odd. I haven't seen any vacant positions advertised on the SAEM website, nor have I heard of any residents commenting on people leaving.

 

[TysonCook]

I'm not sure about resdents leaving, but I usually ask about those things and make a note of it. Even 1-2 residents leaving wouldn't change my mind, just note that the ED in Cincy is very busy and known for being a "learn while you work" place.

I can say after being here for 4 years as a med student, the residents get amazing training, and most get first pick for attending positions. I've been to multiple ED's and I sincerely believe the residents here are very very very well trained.

Do keep in mind that they work hard at Cincy, but that is a good thing if you want to learn. The also publish a TON of articles and many go to academics when finished.

I can ask the ED rotator in the MICU w/me about residents leaving, but in his opinion he absolutely loves it here, and strongly encourages me to rank it first (and notes he would again as well).

 

[southerndoc]

I'm not sure about resdents leaving, but I usually ask about those things and make a note of it. Even 1-2 residents leaving wouldn't change my mind, just note that the ED in Cincy is very busy and known for being a "learn while you work" place.

I really believe that if you see too few patients, it comprimises your learning moreso than seeing too many (which can compromise patient safety). I found the perfect mix where I am, and I have never complained about the volume of patients I see. It's exactly perfect for me.

There is something to be said about the fact that some people might say "yea, I've read about that" while a resident who trained in a busy place could say "yea, I've seen that." At least we know the latter should have read up on management of the patient he/she saw.

My vote is for higher volume facilities or at least busy patient/resident ratios. Work hard, for you can play during your off-time.

 

[Hercules]

My vote is for higher volume facilities or at least busy patient/resident ratios.

This is a ratio that I found myself thinking about last year when I was interviewing. I remember doing the math and wondering if residents at a program with 60 residents and 150K visits really saw many more than residents at a program with 20 residents and 50K visits.

 

[southerndoc]

This is a ratio that I found myself thinking about last year when I was interviewing. I remember doing the math and wondering if residents at a program with 60 residents and 150K visits really saw many more than residents at a program with 20 residents and 50K visits.

That's why ratios are important.