Best New England EM Programs

[medicine6]

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I don't want to live in New York City and am looking at anywhere else in New England/Northeast (e.g., UCONN, Yale, Brown, Baystate, Maine, SUNY Upstate, Albany). I haven't heard much about these programs on the rotation circuit. Thanks

 

[fiznat]

A guy who just graduated from my school is doing his first year at Baystate. Maybe he'll pop on here, but he seems really happy with the program so far. They seem very resident friendly, one of the hidden gems. I believe they are opening up a brand new ED as we speak, which is a good thing because the old place was super busy and frankly a bit of a zoo. I am from CT, am considering Baystate, and I've heard a lot of good things about that program.

I used to work EMS in Hartford CT, so I've had a lot of contact with the UCONN program at Hartford Hospital as well. I guess I can't say much about the program itself, but I can say that there are a lot of good people there, they have really nice facilities and they definitely stay very busy. There is also talk about expanding the program by a few more slots with cooperation from Saint Francis Hospital, another very busy level II center across town.

I've been to Yale a number of times working EMS, but not enough to say anything about the program. There is always a lot of talk on this forum about Yale but it is difficult to say what is real and what has been blown out of proportion. A quick search will get you more than you'd ever want haha.

I'm sure you'll get more in-depth and program specific reviews from others, but I thought maybe an outsider's perspective might get you started. Hope that helps at least a little bit.

 

[medicine6]

A guy who just graduated from my school is doing his first year at Baystate......Hope that helps at least a little bit.

Thanks, that helps a lot actually. I had read a little about that Yale stuff and had similar feelings as you about it in terms of not knowing enough to have an opinion. Also good to hear those things about Baystate and UCONN because they're both on the short list at this point.

 

[beanbean]

UCONN has also had some issues with firing of a resident for medical issues and another essentially forced out in the last couple of years. The volume of patients and training is good but there are some serious administrative issues.

 

[medicine6]

Would you mind elaborating on that? I don't want to put you in a compromising situation but I would really appreciate more info. It's one thing if a resident did something that deserved firing, it's another if the residents are at a disadvantage there due to these "administrative problems". One of the important things for me in picking a residency is having attendings that support you, are interested in teaching residents, and back you up as their colleague and friend when something bad starts to happen.

 

[Yazo]

I'd try Baystate as one of the above said; they've huge hospitals.

 

[medicine6]

I am attracted to Baystate's volume, but I'm not sure that I would likely see that many more patients in a large volume facility since I'm still just one person. Thus I'm not sure how much it would affect my education as compared to, for example, the quality of teaching, the resident-attending interactions, etc.

 

[southerndoc]

I am attracted to Baystate's volume, but I'm not sure that I would likely see that many more patients in a large volume facility since I'm still just one person. Thus I'm not sure how much it would affect my education as compared to, for example, the quality of teaching, the resident-attending interactions, etc.

Most people learn best by doing. So the more patients you can safely see, the better off you are. You can read and do lectures away from the ED. When in the ED, you need to maximize the number of patient encounters you have. You may not appreciate the attending guiding you on what to do, but it will become your standard practice after many patient encounters. Most attendings won't give you a 5 minute presentation on the latest research after each patient encounter.

 

[medicine6]

I understand what you're saying but my point is I'm likely to see somewhere in the neighborhood of a patient an hour my intern year, regardless of where I work. So the overall volume of the ED likely won't affect my workload or personal volume very much.

 

[gutonc]

I understand what you're saying but my point is I'm likely to see somewhere in the neighborhood of a patient an hour my intern year, regardless of where I work. So the overall volume of the ED likely won't affect my workload or personal volume very much.

I think the point you're missing is that, in a busier ED, the 1pph (or whatever that number ultimately is) that you're going to see has a higher likelihood of being a good learning case than in a slower department. This is not universally true of course but makes for a good approximation.

 

[medicine6]

Ok that's fair enough

 

[Colbert]

I'm from Baystate and I can say that your learning certainly isn't hampered by our volume. The true non-emergencies ("I ran out of Percocet") get funneled to a low acuity area mainly staffed by an attendining and PAs. The rest of the stuff is ours. Your intern year your essentially considered an extra person, so you go at your pace. If that means 4 patients a shift or 10 per shift, thats fine, because your learning. By second year your expected to pick up the pace. Our goal of intern year is for you to find your footing and learn as you go, not see a million patients.

 

[sweetsweetlax]

interesting conversation. Some more food for thought.

At one of my interviews at a smaller ED, they really tried to impress on the applicants that there is a benefit to being at a smaller hospital that doesn't have every residency program under the sun.

Their main point was that as an EM intern at a larger hospital you will be fighting over procedures like intubations, LP's, even suturing with the residents in other programs (mainly Surgery and Anesthesia)

Obviously, they're trying to sell their program, but any thoughts or comments on this from anyone at a larger program?

 

[deleted77919]

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[neusu]

I'm not sure who would be rushing down to the ER to do LPs. You should see plenty of pts with headaches or altered mental status who need taps.

Not infrequent that the ED will call us to do a tap they couldn't get.

 

[SoCuteMD]

interesting conversation. Some more food for thought.

At one of my interviews at a smaller ED, they really tried to impress on the applicants that there is a benefit to being at a smaller hospital that doesn't have every residency program under the sun.

Their main point was that as an EM intern at a larger hospital you will be fighting over procedures like intubations, LP's, even suturing with the residents in other programs (mainly Surgery and Anesthesia)

Obviously, they're trying to sell their program, but any thoughts or comments on this from anyone at a larger program?

I'm at a huge hospital with every residency program. I've not once had to fight for an intubation , LP, or suturing. We own all trauma airways, anesthesia is usually called a few times a year but they are slow to arrive. I have had to push for a chest tube or two but have usually been successful. I have not done a thoracotomy, but have seen two (one done by a trauma fellow and one by a surgery PGY5).

 

[StevieStud]

I have not done a thoracotomy, but have seen two (one done by a trauma fellow and one by a surgery PGY5).

Don't worry, you haven't missed much.

 

[SoCuteMD]

Don't worry, you haven't missed much.

Just the opportunity to spear my fingers on rib fragments. 🙂

 

[migm]

What about UMass vs Baystate?

 

[Lanolin]

I hear MMC is the place to be.

 

[beanbean]

I heard through the grapevine that UCONN's program director is stepping down effective in January 2013. There will an interim director and then in July a new director. The person I who is rumored to take the directorship will be excellent for the program. So for those concerned regarding some negative aspects of the program administration, this may change your thoughts on UCONN. I think it will be very beneficial for the program. They are also adding residency slots (4 more) to the incoming class and will be adding St Francis Hospital in Hartford to the ED rotations. Big changes.

 

[waterman]

So I'll add my 2 cents. Disclaimer: I am an intern at Albany med.

I had no knowledge of this program before I interviewed and only accepted the interview because it was an easy piggyback to another programs interview. For some reason, we’re not on a lot of people’s radar but when I interviewed I fell in love, ranked them, matched and now I couldn’t be happier. We are a busy ED (70,000+) visits per year; we had the most trauma in the state last year and the best outcomes. We have a huge catchment area and only share with a few smaller hospitals. The program is comprised of great people on the attending and resident sides. During shifts you can see as many sick patients as you can handle, but you always hade 2nd and third years to back you up if you need help and the attending are very approachable (I have never had any reservations about asking for help). We have more ED months than any other program I interviewed at (a big plus in my eyes) – you are never scutted out to medicine or surg for floor months. If we are off service it is 1) to get procedures or 2) to get experience. We do ICUs, procedure based rotations (anesthesia, OB, US), or experience based (community, EMS). If you think working in the ED is key to being a good ED doc, then we agree. The ED is also a strong presence in the hospital, I’m not going to go into specifics here but feel free to contact me if you have any questions about why this is a plus.

Outside of the program (aka if life style matters) we have a great schedule with 4 vacation weeks. We work 9hr shifts with 1hour of overlap for documentation. If you are like me and love the outdoors this is a great place to be. When you are off, a 30min to 1hr drive in any direction will get you to great climbing, biking, hiking, running, skiing/boarding, kayaking, etc. There are also plenty of great little mountain towns to explore and the cities are a 2 hour train ride away.

In the end EM is a great specialty. By and large all the people are great and its hare to go wrong with any program. That said, you will find a few that you really want to be a part off. What works for me may not work for you, but I love Albany meds EM residency and couldn’t be happier with my decision. If anyone has any questions about Albany med or the match in general feel free to drop me an email at [email protected] (although I only check it a few times a week).

Jeff

 

[littleasian]

umass has a great program, i rotated there as a med student and also interviewed there. solid didactics, great faculty, lots of volume and plenty of fellowships. they really stress their US curriculum too. only downside is maybe living in worcester but some residents commute from boston too so if you need a big city its totally doable

 

[babi]

I am a resident at Baystate. I cannot comment on other programs but I can tell you that my time at Baystate so far has exceeded all expectations. We are super super busy, very high acuity and extremely supportive environment. It is a combination that is hard to fbeat. Amazing program leadership and happy residents make Baystate a fun place to train.
We see over 100000 patients a year, very sick patients. It is not unusual to have 4-5 intubation in the department during a shift of 9 hours. There is never shortage for procedure, maybe except for obvious ones like thoracotomy and tracheostomy. By mid of second year, you will be carrying 8-9 patients at a time with 5-6 active patients. If you want to see as many patients as possible during your training, never wait for patients, always be on the go, do as many procedures as possible and have fun while doing all of it, then Baystate is a place for you. If you like somewhat of a slower pace, more controlled setting then consider other places. Western mass is a beautiful region with tons of outdoor activities and a great place for raising children. Good luck with everything and send me a message if you have other questions.

 

[Deuce Doc]

I did a review of Baystate after my interview last year, so this is more of the same. Really great group of people in my judgement. The PD seemed outstanding.

 

[cpants]

interesting conversation. Some more food for thought.

At one of my interviews at a smaller ED, they really tried to impress on the applicants that there is a benefit to being at a smaller hospital that doesn't have every residency program under the sun.

Their main point was that as an EM intern at a larger hospital you will be fighting over procedures like intubations, LP's, even suturing with the residents in other programs (mainly Surgery and Anesthesia)

Obviously, they're trying to sell their program, but any thoughts or comments on this from anyone at a larger program?

I really can't imagine a scenario where surgery residents would be fighting to close wounds in the ER or anesthesia is fighting for intubations. They are selling you some major BS. Maybe something more rare/educational like a chest tube would get pilfered, but these consultants are not going to be there unless you call them, and if you call them what do you expect? Your experience will be dictated by the quality and comfort level of your attendings as well as the volume your center sees, not the presence or absence of consulting services.