Away rotation in NYC

[loca Dr. chica]

I would like to do an away rotation in NYC to confirm my career choice and hopefully get some exposure to trauma/procedures. My choices are NY-Presbyterian, St.Luke's-Roosevelt and Elmhurst (Mt Sinai). I would like to learn a lot and hopefully get a great SLOR in the process. Also, does anyone have experience with rotations which require exams at the end? How much time committment would be required in terms of studying? I'm still waiting on SFGH (in San Fransisco), which is currently full. Any thoughts about the order in which I should consider these programs for visiting electives in terms of exposure to variety and trauma, working 1 on 1 w/ attendings, trying to get a good SLOR and ease of living? This is going to be the only EM rotation I'll be doing, so I want to be deliberate in my decision.

Thanks in advance.

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[SoCuteMD]

1) There's not much trauma in NYC. There's lots of variety.
2) Because NYC is a popular away rotation destination, 1-on-1 with the "right" attendings can be difficult to get from what I hear (to circumvent this, I am rotating in NYC and elsewhere as well)
3) Ease of living - NY is easy. It's not cheap. As far as I know, none of the away rotations have housing available in the fall (Columbia MIGHT during the spring, but that's late obviously)

If I were you I wouldn't apply selectively. It's June. Most people I know already have their 2 away rotations lined up. Be aware that NY has some fairly stringent vaccination/titer requirements, so make sure those are up to date. Lots of .

 

[Apollyon]

1) There's not much trauma in NYC. There's lots of variety.

Huh? Where? NY Downtown Hospital? At Elmhurst, they average 6 trauma activations (the trauma team) a day - that's more than 2000 per year. Presbyterian sees 1800 burns per year - most in the country. It's not exaggerating to call Kings County a "knife and gun club".

There is MUCH more than enough trauma to go around in NYC.

 

[SoCuteMD]

Huh? Where? NY Downtown Hospital? At Elmhurst, they average 6 trauma activations (the trauma team) a day - that's more than 2000 per year. Presbyterian sees 1800 burns per year - most in the country. It's not exaggerating to call Kings County a "knife and gun club".

There is MUCH more than enough trauma to go around in NYC.

When people say "NYC" I think "Manhattan." Bad habit, I guess. Manhattan is short on trauma. Just ask any current or recent graduate of a Manhattan EM program. King's County and Lincoln are probably the only two "knife and gun clubs" left in the five boroughs - neither of those two were on the OP's list so I didn't comment. I'll admit that I don't know much about the trauma situation at Elmhurst, but I was under the impression that of the residents from the programs in Manhattan (in which I include Mt. Sinai), those at Bellevue saw the most with everyone else coming up a distant 2nd.

Presby may see a lot of burns, but burns alone do not equal trauma. Even the NYP residents will acknowledge that they are short on trauma.

 

[nymbarra]

I believe NY Hosp Queens and/or Long Island Jewish send their residents to Elmhurst for trauma and procedures.

Good luck w/ your AI's!

 

[Apollyon]

North Shore goes to Elmhurst for trauma, too.

 

[RxnMan]

1) There's not much trauma in NYC. There's lots of variety...

😕 Could you please explain what you mean by this?

 

[Egon]

Elmhurst has a lot of trauma ...three thoracotomies on Christmas my last year there. A lot of people get hit by cars on Queens Blvd as well...
I think all the hospitals outside of Manhattan see plenty of trauma.

For away electives, Elmhurst is great. You can also combine it and do half Sinai and half Elmhurst. There are so many resussitations at Sinai b/c of nursing home contracts, etc.

I think they have a test at the end but you will be guided on what you need to study.

 

[jbar]

Are people really saying that Bellevue doesn't get trauma?

 

[SoCuteMD]

😕 Could you please explain what you mean by this?

Variety in pathology. The OP asked about it in the same sentence as trauma.

 

[SoCuteMD]

Are people really saying that Bellevue doesn't get trauma?

As far as I know, Bellevue gets the most trauma of any place in Manhattan (with NYP coming up first in burns, as Appollyon pointed out). However, it's a well-acknowledged fact (or consistently propogated rumor) that Manhattan numbers for trauma have greatly decreased in the last ten years. I didn't mention Bellevue in my first response because the OP only asked about St. Luke's-Roosevelt, NYP, and Sinai/Elmhurst.

 

[RxnMan]

Variety in pathology. The OP asked about it in the same sentence as trauma.

Cool. Thanks.

 

[roja]

Actually-

there is enough trauma, however, there is a misconception as to HOW MUCH trauma there is in nyc.

*ALL* sites in nyc have seen dramatic decreases in the number of serious traumas (particularly knife and gun). Its still there, don't get me wrong. Its just not a daily/nightly event. I have friends at almost all residencies in nyc. There really are no more hard core knife and gun clubs... at least not like they were in the 80's and early 90's.

However, residents wig on trauma (myself included) thinking you need gobs and gobs and gobs. then once you get it, you realize, trauma is very very very protocolized. Its really not that complicated.

complex medical patients, that's what will make you pee your proverbial pants.

 

[missedtackle]

I have a question on timing of away rotations. Does anyone think it makes a big difference whether or not I do it in Sept or Oct, in terms of getting grades in, recs that count, or a decision to offer an residency interview on the part of the program?

 

[BlondeDocteur]

Beating a dead horse here, but Roja's right. In Manhattan, no one drives cars. If they do drive cars, they don't drive them fast, and 70% of all cars on the road at one time are handled by professional drivers. This means no car wrecks. When there are serious high-velocity wrecks on I-95, they mainly go to Einstein in the Bronx-- they're the closest. This applies to all hospitals in Manhattan, including Bellevue.

Crime is down. This is great! But it does mean no one is randomly shot or stabbed for their shoes anymore to buy $3 worth of crack. The drug trade is still thriving, but people are more accurate-- we see more DOAs than we do salvageable patients. My friends at King's County, however, do say that they get so many trauma alerts that third year med students end up running them some nights.

As far as variety goes-- there are 18 million people in this city who literally come from every nation and province on this planet. Get used to making exotic differentials, particularly if you rotate in a place like Elmhurst, which happens to be located in the most diverse neighborhood in the entire world. 170+ countries represented in one zip code.

 

[JackBauERfan]

Beating a dead horse here, but Roja's right. In Manhattan, no one drives cars. If they do drive cars, they don't drive them fast, and 70% of all cars on the road at one time are handled by professional drivers. This means no car wrecks. When there are serious high-velocity wrecks on I-95, they mainly go to Einstein in the Bronx-- they're the closest. This applies to all hospitals in Manhattan, including Bellevue.

Crime is down. This is great! But it does mean no one is randomly shot or stabbed for their shoes anymore to buy $3 worth of crack. The drug trade is still thriving, but people are more accurate-- we see more DOAs than we do salvageable patients. My friends at King's County, however, do say that they get so many trauma alerts that third year med students end up running them some nights.

As far as variety goes-- there are 18 million people in this city who literally come from every nation and province on this planet. Get used to making exotic differentials, particularly if you rotate in a place like Elmhurst, which happens to be located in the most diverse neighborhood in the entire world. 170+ countries represented in one zip code.

I have to agree with everyone here...I'm at Lincoln and dont' get me wrong there are a good number of trauma activations; but nightly gun/knife club is not the norm; but from what I understand the crime rate in NYC is a lot lower than 15-20 years ago. I've spoken to a few attendings that have been at Lincoln awhile and they have told me it used to be a lot crazier....

Does that mean you don't get your trauma experience, I dont think so. I'm sure you'll get a decent trauma experience anywhere you go and should feel comfortable when you are done, and Roja's right, the money is on getting good with complex medical patients!

 

[Universe_Explorer]

I would like to do an away rotation in NYC to confirm my career choice and hopefully get some exposure to trauma/procedures. My choices are NY-Presbyterian, St.Luke's-Roosevelt and Elmhurst (Mt Sinai). I would like to learn a lot and hopefully get a great SLOR in the process. Also, does anyone have experience with rotations which require exams at the end? How much time committment would be required in terms of studying? I'm still waiting on SFGH (in San Fransisco), which is currently full. Any thoughts about the order in which I should consider these programs for visiting electives in terms of exposure to variety and trauma, working 1 on 1 w/ attendings, trying to get a good SLOR and ease of living? This is going to be the only EM rotation I'll be doing, so I want to be deliberate in my decision.

Thanks in advance.

OP,
You'll get a great experience and SLOR from any of the large NYC programs (the three you mentioned, plus Bellevue, Jacobi, and Kings County). To be honest, you'd probably get just as good an experience at some of the smaller programs as well (NYHQ supposedly has a great 4th year rotation). I think the trauma discussion above is sort of moot - while there is less trauma in Manhattan than other cities, it won't really effect the quality of your rotation as a student either way. As a student rotating in EM the vast majority of your time is (and should be) focused on the general EM patients - not the trauma activations. Personally, I was a lot more involved in trauma during my 3rd year surgery rotation than either 4th year EM rotation, and that's the way it was at both places I rotated (one of which was Bellevue). Bellevue and Columbia/Cornell write one unified SLOR for each student using info compiled from the attendings and residents that work with you, I'm not sure about the others. I'm not sure who has exams at the end. As for time studying - like anything else in life, you get out what you put in. ED months are not easy, but most do give you more time off than you're used to from 3rd year, so there's time for reading. Ease of living will be your toughest part if you don't have a friend or a place to stay in the city - I don't think any of these programs offer housing for elective students, so you'll have to find a sublet from somewhere. Good luck

 

[ggmk]

I would like to do an away rotation in NYC to confirm my career choice and hopefully get some exposure to trauma/procedures. My choices are NY-Presbyterian, St.Luke's-Roosevelt and Elmhurst (Mt Sinai). I would like to learn a lot and hopefully get a great SLOR in the process. Also, does anyone have experience with rotations which require exams at the end? How much time committment would be required in terms of studying? I'm still waiting on SFGH (in San Fransisco), which is currently full. Any thoughts about the order in which I should consider these programs for visiting electives in terms of exposure to variety and trauma, working 1 on 1 w/ attendings, trying to get a good SLOR and ease of living? This is going to be the only EM rotation I'll be doing, so I want to be deliberate in my decision.

Thanks in advance.

I'd also recommend doing a rotation at Maimonides Medical center. It's one of the most under-rated programs out there. And not that it's rated low at all, but there are just so many solid programs in NYC that Maimo often doesn't get the spotlight that it deserves, and I imagine it's much easier to signup for an elective there, especially if you just started to think about it in June when most places probably already have their early months filled.

The learning at Maimonides is excellent and the faculty loves to teach. The chair Dr. Davidson is one of the earliest EM trained physicians and in turn trained lots of directors out there and knows everyone in EM, but is still very involved with the education and you'll get lectures from him. The pathology and acuity there is absolutely amazing, just as good or even better than many big county programs yet it runs well like a well-funded private hospitals with brand-new facilities and strong ancilliary staff, which is like the best of both worlds.

Even if Maimo is not a top choice for you, it's still a good idea to do an elective there. You won't be under-pressure to impress them anyways if they're not your top choice, and then you'll walk away with more learning and procedures than you'll ever do as a medical student, and then do electives else where with that under your belt. After Maimo, it should feel like a walk in the park at most places and you could impress more and increase your chance of matching at your real top choice.

Good Luck.

 

[c.bear]

On the issue of trauma, NYHQ gets some good blunt trauma as we are the receiving hospital for Laguardia Airport and Shea Stadium - and surrounding highways. But we go to Las Vegas for penetrating trauma as crime is low all over New York. My plug for NYHQ is that we do have great teachers and have tons of good critical care medicine cases - much more tough.

 

[quideam]

NY - Presbyterian doesn't have a lot of major trauma, but the EM residents and attendings are great and do a lot of teaching... also that rotation is a mixed Cornell/Columbia rotation so you get to do EM in two different hospitals (one on the upper east side and the other in Harlem). But, also, I agree - apply ASAP because these spots go quickly!

 

[KCAccidental]

Random question, but when do you all think would be the latest date that you would cancel an away rotation? I have heard that canceling late is looked upon poorly (understandably so) and that in the NYC EM community programs talk to each other, so I wanted to know what was considered "late". Any insight is greatly appreciated.

 

[roja]

Anything after 6-8 weeks is pretty late.

 

[xavier2000]

Bellevue is remarkable for the academic side of things from what I hear. Conferences, lectures, etc... Lincoln not so much knife and gun anymore? Guess that is good.

 

[JackBauERfan]

Bellevue is remarkable for the academic side of things from what I hear. Conferences, lectures, etc... Lincoln not so much knife and gun anymore? Guess that is good.

actually probably knives still...i say no and then a night of knives haha.

 

[a_ditchdoc]

I did a rotation at SLR as well as Columbia/Cornell. They are both great programs with very different feels to them. NY Presby and Cornell have an extraordinary contrast. Presby has a kind of gritty feel that I loved with lots of chaos and the occasional crackhead rolling around on the floor. Cornell had many well heeled, upper class clients and extraordinary facilities, something that that I surprisingly did not prefer. The staff are shared a bit, as are all of the residents but I strongly preferred Presbyterian. Their academics/conferences are the best I have ever attended anywhere.

SLR was a great rotation. It is very student friendly. They have the happiest residents I have met anywhere and they are all treated well by the residency program. They enjoy teaching and you share your experience between two locations. You will see a very diverse patient population at either place with lots of acuity.

As far as trauma goes, you should not count on much in Manhattan. I see more trauma in Detroit on a busy night that I did in several months in Manhattan. Of course you have the rare shooting or serious MVC, but it is uncommon. I was a little surprised by this. I did an entire month of trauma surgery in Manhattan and saw only general surgery, nothing traumatic at all. It is good for the population I suppose.

I hear the Lincoln program and some of the other programs, known for their knife and gun clubs, still have a respectable amount, at least from word of mouth.

I know that as a student you want to get your "feet wet" in a place with lots of trauma, but it does lose it's glitter rather quickly and will do nothing to bolster your application. As a student it is certainly interesting to see. Although you sometimes get to assist as a student, if it is a really serious trauma the residents and attendings will be doing nearly everything, especially if you are in a place where trauma is sparce.

Best of luck with you elective...