Chronic_LBP
New Member
- Joined
- Apr 9, 2019
- Messages
- 2
- Reaction score
- 0
It's been some time since I read the reviews and eventually became a resident. For some reason I cannot simply post under the original review thread so I am posting here. I cannot speak to how the program was in the past, but I want to clarify what the program is like now. I think I speak for all current residents, recent graduates, and even those who know of the program from Detroit that we all share a great deal of pride in Sinai-Grace and Detroit EM. First and foremost, if you're looking for some strong emergency medicine training you will be remiss if you did not take a good look at Detroit and particularly take a long hard look at what we have at Grace. There is so much end-stage pathology that cannot be accurately described by reading a review or attending a 1-day interview tour that could ever explain what northwest Detroit has to offer for training.
I would choose this program again and believe I got one of the best possible EM experience I could ask for because of the patient population, pathology, faculty, autonomy, work-life balance and the sheer amount of resuscitation/ICU experience we get which has led to dozens of graduates going into some great critical care fellowships after graduating. After training at Sinai-Grace you will definitely be able to practice anywhere you want.
I will attempt to directly address the concerns I noted in a prior review
RESIDENTS – As of this year, there will be 16 per year, but initially it was 12/year. Leadership as Sounds stated we have been approved for 14-16 residents for some time and finally it happened. We have a mixture of local and out of state applicants, including a couple of American born FMGs, a mixture of MDs and DOs, who are ranked as an individual, more than their alma mater. Check out the wordpress website for more details.
SHIFTS - 18-19-18, (9 hour shifts with 1 hour overlap to the new team, pick up for 7.5-8 hours) where intern year the 18 include 1 EMS run, intern teaching sessions which are intern only didactics led by the education chief through a curriculum, and ultrasound shifts. As mentioned in prior posts, we work our ass off when we are on, but we feel we get plenty of time away from the department to spend time either for ourselves, studying advance our own education, or develop a niche within medicine. As senior residents, we will often stay 1-2 hours after you pick up your last patient, but this is the trade-off for the resuscitation heavy pathology we get to see. Wouldn't trade it at all. Plus, once you get well into your second year, your list of macros and speed at using Dragon should get you out on-time or not far from it. We find that once you get well into your second year you list of macros and speed at using Dragon should get you out on-time or not far from that. You will be a Dragon tamer by the middle/end of PGY2. We use Shift Admin for our schedules and it’s very easy to get time off if requested early in advance and you’re not someone who requests in ridiculous frequency.
FACILITIES: New ED as of 2015, and like I said it already seems warn in. It's a big ED with a footprint larger than most that I came across on my interview trail. Anything that our EM program spends more than 1 month at has been renovated or completely shifts to a new building in the last 5 years. We have recently transitioned from an old classroom to the basement auditorium for grand rounds, a great change for this year.
NURSING: Previous posters mentioned that nursing can be an issue, which is partially true. There is rapid turnover of nursing, which is partly due to the organization which currently owns the DMC, the tough environment, and patient population. They are also very busy and often end up with more patients than they can handle. It does occasionally spill over to our work and time to disposition, but I see the silver lining allowing us to get better at basic procedures and logistical aspects of the department. There can be days where you're doing a few U/S PIVs, helping a nurse/RT/tech push a patient to a scanner but that's truly out of necessity for efficient and faster results for the acuity that comes with our patients. These US guided PIVs help significantly improve all US-guided procedures such as central and arterial lines, nerve blocks, LPs, etc. You will be exceptional at needle control by the end of your intern year.
SCUTWORK: Our scutwork primarily consists of ultrasound IVs or EJs in difficult patients. We will place difficult foleys/PEG tubes and set up our own procedures. We do have to follow up on orders to make sure they are done with some of the nursing staff, which can be labor intensive. Off service rotations tend to have more scutwork than our home institution.
TRAUMA: From a previous poster: "hands down tons of trauma and the best part of this residency but trauma isnt everything and certainly doesnt make up for the vast deficiencies of this program. dont get me wrong i love the trauma, but most of us will end up in a community setting where we wont see a lot of trauma or if you do work in a trauma center trauma surg pretty much runs the show. however we are the exception here as trauma sits back and watches."
The vast deficiencies sentiment is a little obtuse, but I’m going to just going to leave this and not add much else. By the time trauma arrives we have already performed our primary and secondary surveys, and hopefully placed the life or limb saving measure by the time they walk the quarter mile it takes to get to us. We have a good relationship with the trauma service and learn quite a bit from their attendings. A few notable attendings come to grand rounds to comment on cases, and we often implement their suggestions our very next shift. It really is trauma at the highest level.
CURRICULUM:
Medicine/ICU: We do 1 month of medicine floors as well as inpatient cardiology, which is all subject to change. We have a lot of ICU experience, but the ICU is probably the best experience I could imagine. At the moment, it is 3 MICU (2 intern, 1 PGY2 senior month), 1 PICU (PGY2), 1 NICU (PGY3), and 1 SICU (PGY3), with 2 elective months between PGY2-3 to potentially do another or go to CICU at Harper.
MICU: No fellows. Attendings round in the morning and are typically gone by noon, so the rest of the day/ call is left to the senior PGY2resident. The MICU is organized into 4 teams: 1 EM, 3 IM teams. IM teams have 2 senior residents (PGY2 or 3) with 3-4 interns and a few medical students. EM team is made up of a PGY2 and 2 interns with maybe one medical student. Our team is smaller than the medicine team, which is a testament to the respect our program gets in our facility. We triage and deal with ALL MICU consults throughout the entire hospital on our call days, not to mention manage the entirety of the ICU after the other teams have left for the day. All procedures or decisions are ours, and if we have a truly difficult question attendings in the ED are downstairs and your ICU attending is a phone call away. It sounds daunting, but ICU is really a wonderful experience that makes you learn quickly. You're forced to prepare ahead of time, reading all of the landmark ICU trials and articles to ensure the best for your patients. This rotation, in addition to the heavy resuscitation in the ED has led to dozens of graduates going to CC fellowships in the last few years including nearby UMich and other places like WashU and Jacobi-Monte.
EBM/academia - With a large number of younger physicians who have either completed an advanced degree in something surrounding research methodology, EBM has become the forefront of our education. EBM has been so engrained into the culture at Grace that we have extensive longitudinal curriculums to ensure graduates have the best possible critical appraisal understanding outside of a degree. I cannot stress this point enough that EBM a large part of our education here It really feels like not a single article, whether it be from a lower impact journal or landmark trial isn’t brought up or discussed in some fashion. We are regularly asked to back up our claims and attendings routinely direct us toward references to put in our databanks.
RESPONSIBILITIES: There is no graduated responsibility here. Interns usually get first crack at all procedures unless it requires the best provider in the room, then it will go to the senior resident if there is one present. Regarding administrative issues, we are sheltered quite a bit and don’t have to spend much effort learning about the problems our administration may have to face.
FACULTY: The faculty here are some of the best people I have ever met. The will vouch for you with their own careers on the line. I cannot stress how welcoming and helpful they have been to us. Any shifts where there isn’t a significant amount of direct teaching is because of the time we spend away from the computers seeing patients. I really have no problems with this. If we have questions, our attendings will stop anything they are doing and teach you anything you want in almost any situation. Most will be certain to cite historic articles in defense of their teaching so that they can fully explain why we do anything that we do.
DIDACTICS: The program still has protected lecture time 5 hrs per week on Thursdays. It is important to note that we have 100% PROTECTED TIME and all off services understand this, with exception of MICU and SICU senior resident on call. I think this is fairly unique or at least many programs don’t have this much protected time. About half of the lectures are resident based and depending on the topic the EM/visiting faculty will argue amongst themselves or chime in with their input. Previous posters have mentioned that faculty doesn’t chime in as much as they would like, and I agree that sometimes the best part of grand rounds is when faculty get fired up. We have special guests every few months, most notably Jeff Kline this year.
CAMARADERIE: I love the current classes and the classes I have interacted with in the past. I wouldn't change anything about the camaraderie. We know our program is awesome, I just happen to be the first to write something about it now because it seems misrepresented. Our program director and assistant program directors are our advocates in a way I wasn’t expecting, and they actually do have our best interests in mind. Since I’ve been aware of the program it has not had a toxic culture, the opposite actually.
ATMOSPHERE: The original post mentioned local hospital/community politics and concerns for a malignant environment. There is absolutely some bureaucracy here, but certainly not the level that you will see at university/tertiary care centers. Recent graduates who are doing fellowships at U of M are surprised at the red tape they have to cross to do what they consider routine tasks. We are fairly sheltered from the administrative issues outside of certain metrics, site visits, and weekly emails, and I think this is for the better. In regard to the malignant environment, I cannot speak to what it was like over a decade ago, but that could not be further from the truth and I think if you look around at other reviews of our program, we have a great relationship with everyone in our department and those who set foot in it. An attending-resident dynamic is still there, but honestly would consider most of my attendings friends, and they would all say the same. We get a lot of room to fight to justify our rationales and approach to management, then grab food/drink after it’s all over. There is a lot of intentional, on-shift clinical teaching, all directed towards managing the patient in front of you or the one you’re presenting. Our shop is so busy that attendings still have to see a large bulk of the patients. We still see upwards of 1.5-2.5 patients per hour with that number increasing linearly as you progress. Seeing 2.5 patients per hour in our shop is very different from maybe another where the footprint of the ED is smaller and you can get everything you want from the patient within a few minutes because of the social class of our patient population. We also spend quite a bit of time rechecking tenuous patients and ensuring tasks are completed.. On average, attendings and senior residents are all very busy, but the moment you ask them for help or want to learn something, they will happily find a moment and stop what they are doing to provide what they can in the busy environment.
Additionally, we do not see most level 4-5 triages (lowest acuity) as those are siphoned off to the fast track/express care (what we call “E team” covered by mid-levels), helping to heighten the acuity of the average patient that we as residents see in the main ED. Since previous posts DMC was bought by Tenet. One thing to mention is the dynamic between Wayne State, DMC, Tenet, and the EM group that covers all DMC emergency departments. MCES is the group that services all DMC emergency departments and is completely separate from these entities and if anything were to happen with Wayne State or DMC, the EM group would be just fine and will not have any impact on educating residents.
LOCATION: Sinai Grace is located in Northwest Detroit in an impoverished community on seven mile. As mentioned before residents do not live in the immediately surrounding neighborhoods, but do typically live within a 10-20 minute drive downtown or in nearby suburb towns. Detroit has been making a notable comeback which is definitely worth learning about, but the result of that is the downtown area is awfully nice. Which is great if you want to live there, but not if you want to be a cool-as-hell ER doc. The capture area for ambulances covers quite a bit of the city and definitely seems to bring in the most high level/complex patients.
Since this post, DMC was bought by Tenet. One thing to mention is the dynamic between Wayne State, DMC, Tenet, and the EM group that covers all DMC emergency departments. MCES is the group that services all DMC emergency departments and is completely separate from these entities and if anything were to happen with Wayne State or DMC, the EM group would be just fine and will not have any impact on educating residents.
Because metro-Detroit has a large density of EM programs and other residencies, it is a great location for those who couples match. In regards to couples and families, this is a family friendly program that is happy to help if you end up starting a family. Many of our co-residents have had multiple children while in residency and the program will help rearrange everything to allow for that.
SUBSPECIALTIES – We have just about every EM subspecialty within the house of DMC or Detroit as a city In addition to ultrasound, tox, EMS, and pediatrics, the DMC proper has implemented a brand new medical education fellowship which was started by one of our former assistant program directors. This past year, our graduates who wanted to complete a fellowship at home in Detroit got what they wanted. The 1 EMS spot, 1 toxicology spot, 1 of 3 ultrasound spots were all filled by Grace residents.
Ultrasound - I have to speak to our ultrasound training here because it’s the most robust and arguably strongest subspecialty education that we get as residents. We have Q-Path and utilize Zonares, with 1 machine dedicated to each side of the ED, 1 free floating, and 2 for resuscitation rooms During any given shift there will be 1-2 ultrasound trained or ultrasound faculty working who we often go to for advice and review of our imaging. The ultrasound faculty of the Detroit US fellowship are all equally spread out between Grace, Receiving, and St. John’s. Each program features US faculty that preferentially practice at their shops, and I swear we all think our faculty is the best. I think this is a testament to how great the US training is in Detroit. Every year we have an ultrasound skills competition called SONO cup that brings all the programs together and pits them against each other at a trendy venue with loud music. Grace typically smashes the other programs so take that for what it’s worth..
CONS: Sinai Grace is located in a rough community, we are paid slightly below the national average, our workload on shift is high, and residents have to ensure orders are completed in a timely manner other than other programs. One of our current residents has been advocating for pay increases and meal cards, which were both implemented this year. It is very unusual for residents to moonlight as they are required to have both their academic and quality assurance projects completed before being granted permission.
ADVICE: Ask any of us questions. We will absolutely be partial to our program, but it's because we love it and call it home. Most of us feel like we own it in some way and feel we own it in some way. You are more than welcome to email or message any of us before, during, or after your time with us and we can give you our perspective as to why we chose this place over many other programs. Many of us will even talk about our rank list as a medical student with fairly long descriptions as to why we ranked them where they are and why we think many places across the country will get you wonderful training. The Midwest EM community is excellent, Detroit is an amazing place to train regardless, but Sinai Grace is truly a special place among a lot of great places.
I would choose this program again and believe I got one of the best possible EM experience I could ask for because of the patient population, pathology, faculty, autonomy, work-life balance and the sheer amount of resuscitation/ICU experience we get which has led to dozens of graduates going into some great critical care fellowships after graduating. After training at Sinai-Grace you will definitely be able to practice anywhere you want.
I will attempt to directly address the concerns I noted in a prior review
RESIDENTS – As of this year, there will be 16 per year, but initially it was 12/year. Leadership as Sounds stated we have been approved for 14-16 residents for some time and finally it happened. We have a mixture of local and out of state applicants, including a couple of American born FMGs, a mixture of MDs and DOs, who are ranked as an individual, more than their alma mater. Check out the wordpress website for more details.
SHIFTS - 18-19-18, (9 hour shifts with 1 hour overlap to the new team, pick up for 7.5-8 hours) where intern year the 18 include 1 EMS run, intern teaching sessions which are intern only didactics led by the education chief through a curriculum, and ultrasound shifts. As mentioned in prior posts, we work our ass off when we are on, but we feel we get plenty of time away from the department to spend time either for ourselves, studying advance our own education, or develop a niche within medicine. As senior residents, we will often stay 1-2 hours after you pick up your last patient, but this is the trade-off for the resuscitation heavy pathology we get to see. Wouldn't trade it at all. Plus, once you get well into your second year, your list of macros and speed at using Dragon should get you out on-time or not far from it. We find that once you get well into your second year you list of macros and speed at using Dragon should get you out on-time or not far from that. You will be a Dragon tamer by the middle/end of PGY2. We use Shift Admin for our schedules and it’s very easy to get time off if requested early in advance and you’re not someone who requests in ridiculous frequency.
FACILITIES: New ED as of 2015, and like I said it already seems warn in. It's a big ED with a footprint larger than most that I came across on my interview trail. Anything that our EM program spends more than 1 month at has been renovated or completely shifts to a new building in the last 5 years. We have recently transitioned from an old classroom to the basement auditorium for grand rounds, a great change for this year.
NURSING: Previous posters mentioned that nursing can be an issue, which is partially true. There is rapid turnover of nursing, which is partly due to the organization which currently owns the DMC, the tough environment, and patient population. They are also very busy and often end up with more patients than they can handle. It does occasionally spill over to our work and time to disposition, but I see the silver lining allowing us to get better at basic procedures and logistical aspects of the department. There can be days where you're doing a few U/S PIVs, helping a nurse/RT/tech push a patient to a scanner but that's truly out of necessity for efficient and faster results for the acuity that comes with our patients. These US guided PIVs help significantly improve all US-guided procedures such as central and arterial lines, nerve blocks, LPs, etc. You will be exceptional at needle control by the end of your intern year.
SCUTWORK: Our scutwork primarily consists of ultrasound IVs or EJs in difficult patients. We will place difficult foleys/PEG tubes and set up our own procedures. We do have to follow up on orders to make sure they are done with some of the nursing staff, which can be labor intensive. Off service rotations tend to have more scutwork than our home institution.
TRAUMA: From a previous poster: "hands down tons of trauma and the best part of this residency but trauma isnt everything and certainly doesnt make up for the vast deficiencies of this program. dont get me wrong i love the trauma, but most of us will end up in a community setting where we wont see a lot of trauma or if you do work in a trauma center trauma surg pretty much runs the show. however we are the exception here as trauma sits back and watches."
The vast deficiencies sentiment is a little obtuse, but I’m going to just going to leave this and not add much else. By the time trauma arrives we have already performed our primary and secondary surveys, and hopefully placed the life or limb saving measure by the time they walk the quarter mile it takes to get to us. We have a good relationship with the trauma service and learn quite a bit from their attendings. A few notable attendings come to grand rounds to comment on cases, and we often implement their suggestions our very next shift. It really is trauma at the highest level.
CURRICULUM:
Medicine/ICU: We do 1 month of medicine floors as well as inpatient cardiology, which is all subject to change. We have a lot of ICU experience, but the ICU is probably the best experience I could imagine. At the moment, it is 3 MICU (2 intern, 1 PGY2 senior month), 1 PICU (PGY2), 1 NICU (PGY3), and 1 SICU (PGY3), with 2 elective months between PGY2-3 to potentially do another or go to CICU at Harper.
MICU: No fellows. Attendings round in the morning and are typically gone by noon, so the rest of the day/ call is left to the senior PGY2resident. The MICU is organized into 4 teams: 1 EM, 3 IM teams. IM teams have 2 senior residents (PGY2 or 3) with 3-4 interns and a few medical students. EM team is made up of a PGY2 and 2 interns with maybe one medical student. Our team is smaller than the medicine team, which is a testament to the respect our program gets in our facility. We triage and deal with ALL MICU consults throughout the entire hospital on our call days, not to mention manage the entirety of the ICU after the other teams have left for the day. All procedures or decisions are ours, and if we have a truly difficult question attendings in the ED are downstairs and your ICU attending is a phone call away. It sounds daunting, but ICU is really a wonderful experience that makes you learn quickly. You're forced to prepare ahead of time, reading all of the landmark ICU trials and articles to ensure the best for your patients. This rotation, in addition to the heavy resuscitation in the ED has led to dozens of graduates going to CC fellowships in the last few years including nearby UMich and other places like WashU and Jacobi-Monte.
EBM/academia - With a large number of younger physicians who have either completed an advanced degree in something surrounding research methodology, EBM has become the forefront of our education. EBM has been so engrained into the culture at Grace that we have extensive longitudinal curriculums to ensure graduates have the best possible critical appraisal understanding outside of a degree. I cannot stress this point enough that EBM a large part of our education here It really feels like not a single article, whether it be from a lower impact journal or landmark trial isn’t brought up or discussed in some fashion. We are regularly asked to back up our claims and attendings routinely direct us toward references to put in our databanks.
RESPONSIBILITIES: There is no graduated responsibility here. Interns usually get first crack at all procedures unless it requires the best provider in the room, then it will go to the senior resident if there is one present. Regarding administrative issues, we are sheltered quite a bit and don’t have to spend much effort learning about the problems our administration may have to face.
FACULTY: The faculty here are some of the best people I have ever met. The will vouch for you with their own careers on the line. I cannot stress how welcoming and helpful they have been to us. Any shifts where there isn’t a significant amount of direct teaching is because of the time we spend away from the computers seeing patients. I really have no problems with this. If we have questions, our attendings will stop anything they are doing and teach you anything you want in almost any situation. Most will be certain to cite historic articles in defense of their teaching so that they can fully explain why we do anything that we do.
DIDACTICS: The program still has protected lecture time 5 hrs per week on Thursdays. It is important to note that we have 100% PROTECTED TIME and all off services understand this, with exception of MICU and SICU senior resident on call. I think this is fairly unique or at least many programs don’t have this much protected time. About half of the lectures are resident based and depending on the topic the EM/visiting faculty will argue amongst themselves or chime in with their input. Previous posters have mentioned that faculty doesn’t chime in as much as they would like, and I agree that sometimes the best part of grand rounds is when faculty get fired up. We have special guests every few months, most notably Jeff Kline this year.
CAMARADERIE: I love the current classes and the classes I have interacted with in the past. I wouldn't change anything about the camaraderie. We know our program is awesome, I just happen to be the first to write something about it now because it seems misrepresented. Our program director and assistant program directors are our advocates in a way I wasn’t expecting, and they actually do have our best interests in mind. Since I’ve been aware of the program it has not had a toxic culture, the opposite actually.
ATMOSPHERE: The original post mentioned local hospital/community politics and concerns for a malignant environment. There is absolutely some bureaucracy here, but certainly not the level that you will see at university/tertiary care centers. Recent graduates who are doing fellowships at U of M are surprised at the red tape they have to cross to do what they consider routine tasks. We are fairly sheltered from the administrative issues outside of certain metrics, site visits, and weekly emails, and I think this is for the better. In regard to the malignant environment, I cannot speak to what it was like over a decade ago, but that could not be further from the truth and I think if you look around at other reviews of our program, we have a great relationship with everyone in our department and those who set foot in it. An attending-resident dynamic is still there, but honestly would consider most of my attendings friends, and they would all say the same. We get a lot of room to fight to justify our rationales and approach to management, then grab food/drink after it’s all over. There is a lot of intentional, on-shift clinical teaching, all directed towards managing the patient in front of you or the one you’re presenting. Our shop is so busy that attendings still have to see a large bulk of the patients. We still see upwards of 1.5-2.5 patients per hour with that number increasing linearly as you progress. Seeing 2.5 patients per hour in our shop is very different from maybe another where the footprint of the ED is smaller and you can get everything you want from the patient within a few minutes because of the social class of our patient population. We also spend quite a bit of time rechecking tenuous patients and ensuring tasks are completed.. On average, attendings and senior residents are all very busy, but the moment you ask them for help or want to learn something, they will happily find a moment and stop what they are doing to provide what they can in the busy environment.
Additionally, we do not see most level 4-5 triages (lowest acuity) as those are siphoned off to the fast track/express care (what we call “E team” covered by mid-levels), helping to heighten the acuity of the average patient that we as residents see in the main ED. Since previous posts DMC was bought by Tenet. One thing to mention is the dynamic between Wayne State, DMC, Tenet, and the EM group that covers all DMC emergency departments. MCES is the group that services all DMC emergency departments and is completely separate from these entities and if anything were to happen with Wayne State or DMC, the EM group would be just fine and will not have any impact on educating residents.
LOCATION: Sinai Grace is located in Northwest Detroit in an impoverished community on seven mile. As mentioned before residents do not live in the immediately surrounding neighborhoods, but do typically live within a 10-20 minute drive downtown or in nearby suburb towns. Detroit has been making a notable comeback which is definitely worth learning about, but the result of that is the downtown area is awfully nice. Which is great if you want to live there, but not if you want to be a cool-as-hell ER doc. The capture area for ambulances covers quite a bit of the city and definitely seems to bring in the most high level/complex patients.
Since this post, DMC was bought by Tenet. One thing to mention is the dynamic between Wayne State, DMC, Tenet, and the EM group that covers all DMC emergency departments. MCES is the group that services all DMC emergency departments and is completely separate from these entities and if anything were to happen with Wayne State or DMC, the EM group would be just fine and will not have any impact on educating residents.
Because metro-Detroit has a large density of EM programs and other residencies, it is a great location for those who couples match. In regards to couples and families, this is a family friendly program that is happy to help if you end up starting a family. Many of our co-residents have had multiple children while in residency and the program will help rearrange everything to allow for that.
SUBSPECIALTIES – We have just about every EM subspecialty within the house of DMC or Detroit as a city In addition to ultrasound, tox, EMS, and pediatrics, the DMC proper has implemented a brand new medical education fellowship which was started by one of our former assistant program directors. This past year, our graduates who wanted to complete a fellowship at home in Detroit got what they wanted. The 1 EMS spot, 1 toxicology spot, 1 of 3 ultrasound spots were all filled by Grace residents.
Ultrasound - I have to speak to our ultrasound training here because it’s the most robust and arguably strongest subspecialty education that we get as residents. We have Q-Path and utilize Zonares, with 1 machine dedicated to each side of the ED, 1 free floating, and 2 for resuscitation rooms During any given shift there will be 1-2 ultrasound trained or ultrasound faculty working who we often go to for advice and review of our imaging. The ultrasound faculty of the Detroit US fellowship are all equally spread out between Grace, Receiving, and St. John’s. Each program features US faculty that preferentially practice at their shops, and I swear we all think our faculty is the best. I think this is a testament to how great the US training is in Detroit. Every year we have an ultrasound skills competition called SONO cup that brings all the programs together and pits them against each other at a trendy venue with loud music. Grace typically smashes the other programs so take that for what it’s worth..
CONS: Sinai Grace is located in a rough community, we are paid slightly below the national average, our workload on shift is high, and residents have to ensure orders are completed in a timely manner other than other programs. One of our current residents has been advocating for pay increases and meal cards, which were both implemented this year. It is very unusual for residents to moonlight as they are required to have both their academic and quality assurance projects completed before being granted permission.
ADVICE: Ask any of us questions. We will absolutely be partial to our program, but it's because we love it and call it home. Most of us feel like we own it in some way and feel we own it in some way. You are more than welcome to email or message any of us before, during, or after your time with us and we can give you our perspective as to why we chose this place over many other programs. Many of us will even talk about our rank list as a medical student with fairly long descriptions as to why we ranked them where they are and why we think many places across the country will get you wonderful training. The Midwest EM community is excellent, Detroit is an amazing place to train regardless, but Sinai Grace is truly a special place among a lot of great places.
