HCA Kingwood EM residency

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TinkleStinkle

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Anyone know anything about this program


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The last thing EM needs. Hope this program never happens.
 
The fact that the residency credentialing committee folks let HCA "do HCA" is both pathetic and telling.
 
I would advise anyone on here with power to never hire people from these residencies. Thats the only approach. I know it is unpopular but we will have a glut of residents as is. IMO the HCA/Envision label is like a **** smear on your face and CV.
 
Ok I'll bite, I went to the RRC website and here are new programs starting just this year . There's 18!?!


Abrazo Health Abrazo Emergency Medicine Residency Program | Abrazo Health Network
Baylor University Medical Center Program, Dallas TX
Capital Health Regional Medical Center Program Trenton NJ
HCA Healthcare LewisGale Medical Center Program
HCA Healthcare/Mercer University School of Medicine/Coliseum Medical Centers Program
HCA Healthcare/Mercer University School of Medicine Program
HCA Houston Healthcare/University of Houston Program
Health Quest Program (this is Borenstein's like 6th program created)
Kaiser Permanente Northern California Program
Magnolia Regional Health Center Program
Memorial Healthcare System, Hollywood, Florida Program
Nazareth Hospital Program
Ochsner Clinic Foundation Program
Riverside Regional Medical Center Program
St Luke’s Hospital – Anderson Campus Program
St. Agnes Medical Center (Fresno) Program
Summa Health System Program
Valley Health System Program
 
theWUbear said:
Ok I'll bite, I went to the RRC website and here are new programs starting just this year (pre-accredidation). There's 18!?!


Abrazo Health Abrazo Emergency Medicine Residency Program | Abrazo Health Network
Baylor University Medical Center Program, Dallas TX
Capital Health Regional Medical Center Program Trenton NJ
HCA Healthcare LewisGale Medical Center Program
HCA Healthcare/Mercer University School of Medicine/Coliseum Medical Centers Program
HCA Healthcare/Mercer University School of Medicine Program
HCA Houston Healthcare/University of Houston Program
Health Quest Program (this is Borenstein's like 6th program created)
Kaiser Permanente Northern California Program
Magnolia Regional Health Center Program
Memorial Healthcare System, Hollywood, Florida Program
Nazareth Hospital Program
Ochsner Clinic Foundation Program
Riverside Regional Medical Center Program
St Luke’s Hospital – Anderson Campus Program
St. Agnes Medical Center (Fresno) Program
Summa Health System Program
Valley Health System Program
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Summa’s back? I thought that hospital internally combusted into a black hole/singularity.
 
1589340135133.png

initial accreditation last sept, per acgme records
 
Okay guys (and gals), let me play Devil's Advocate here for a second. Just a second, okay?

What if THIS happens:

- Covid-19 panic/hysteria goes away, as people realize that they need to "face the beast and roll the dice" sometime.
- ER daily census-es (censi?) return to normal, and surpass "normal", because primary care is generally a wasteland and more Jenny McJennysons will send more patients to the ER because they can't *medicine, even in the least*.
- Jobs continue to grow (albeit slowly) to reflect this increasing demand. Hell; before COVID-19, my shop was hiring 4 BCEM docs to staff their new freestanding ER a few blocks south of the main campus.
- Boomers continue to boom, and will languish in nursing homes for decades. Cardiac catheterization and stenting is replaced with "direct nanospider therapy", where traditional angiography continues up until the point where the catheter-tip can be directed at the lesion, and nanospiders chew the clot away before inactivating and decomposing. Mortality goes down, but morbidity increases, and all of Florida replaces "salt" and "pepper" shakers with "Lasix" and "Digoxin" shakers at their breakfast counters.
- Nursing home patients begin trading cassette tapes of R.E.O. Speedwagon. (LOOK...before anyone gets pissy; I shot myself in the arm with that joke - I was a tot when REO was big, and my adolescence was marked by the purchase of my first CD (Soundgarden; "Superunknown").
- I quit cracking jokes, and get back to making my point that our ever-growing population is not getting healthier or younger, thus resulting in the need for more ER visits; be they "legitimate" or not, because primary care can't do acute care anymore.

Feel free to shoot BIG holes in my timeline here. This post was MADE to be destroyed, amigos.
 
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They were accredited on 4/16. Instead of waiting for the 2021 application cycle so that they could be at full power, they're going ahead with recruiting a sloppy seconds class outside of the match (very few if any EM-committed USMD's/DO's at this point with an overwhelming majority already securing SOMETHING in the form of TY/prelim surgery year). This is telling of the type of dedication to teaching/training found at this place.

I implore anyone with any common sense to avoid going here. As residents, you will get absolutely crapped on by UT Houston and Baylor and will have a hard time being retained to work in the state. This area does not need any more EM residents. The job market in that area and around the country is TIGHT. With a horrible reputation, no alumni-base to provide job networking, and few resources for a proper education, job outlook and future prospects are extremely poor.
 
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I mean, there's an argument to be made that HCA is its own microcosm, training residents to practice within their healthcare system. I interviewed at two HCA programs just for kicks this last cycle, before matching at my #1 and a top EM program, and their motto is "Train and retain." I was thoroughly turned off by their training philosophy, but the residents at both programs seemed to drink the Kool-Aid, and they very much were cogs in the wheel and strangely proud to be "masters" at churning out patients and "moving the meat". That's not the type of medicine I want to practice, but if HCA just wants that, and they train physicians in their mold who somehow buy in to that, I guess that works for them? Don't know, just spitballing here...
 
It filled. With an inaugural class of 12 or 13. Classmate of mine secured a position there.
 
EctopicFetus said:
I would advise anyone on here with power to never hire people from these residencies. Thats the only approach. I know it is unpopular but we will have a glut of residents as is. IMO the HCA/Envision label is like a **** smear on your face and CV.
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Too late for my group. They decided to hire 2 guys from the same HCA program. They are easily the worst 2 docs in our group. Completely uncomfortable with procedures. Overreact when sick patients come in. Can't make decisions for the life of them. They make all the nurses uncomfortable due to how inept they are.

I agree with this quote. If you are responsible for hiring for your group, stay the heck away from HCA trained EM docs.
 
Zebra Hunter said:
Too late for my group. They decided to hire 2 guys from the same HCA program. They are easily the worst 2 docs in our group. Completely uncomfortable with procedures. Overreact when sick patients come in. Can't make decisions for the life of them. They make all the nurses uncomfortable due to how inept they are.

I agree with this quote. If you are responsible for hiring for your group, stay the heck away from HCA trained EM docs.
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you guys gonna cut ‘em loose?
 
Zebra Hunter said:
Too late for my group. They decided to hire 2 guys from the same HCA program. They are easily the worst 2 docs in our group. Completely uncomfortable with procedures. Overreact when sick patients come in. Can't make decisions for the life of them. They make all the nurses uncomfortable due to how inept they are.

I agree with this quote. If you are responsible for hiring for your group, stay the heck away from HCA trained EM docs.
Click to expand...

Hi, I'm a senior resident who currently has the opposite of senioritis - acutely aware that in two months I'm going to enjoy another learning curve as I adjust to attending life. This post scares me a bit - though I've taken advantage of every opportunity in residency, more et/chest tubes/lines than peers; feel comfortable with sick patients (and have heard it will be more the balancing number of patients that will be the learning curve) - can you elaborate on what procedures make a poor new attending uncomfortable, and what you mean by overreacting to a sick patient (too broad a workup? or can't handle high acuity patients in some other way?)
 
theWUbear said:
Hi, I'm a senior resident who currently has the opposite of senioritis - acutely aware that in two months I'm going to enjoy another learning curve as I adjust to attending life. This post scares me a bit - though I've taken advantage of every opportunity in residency, more et/chest tubes/lines than peers; feel comfortable with sick patients (and have heard it will be more the balancing number of patients that will be the learning curve) - can you elaborate on what procedures make a poor new attending uncomfortable, and what you mean by overreacting to a sick patient (too broad a workup? or can't handle high acuity patients in some other way?)
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This post scares me a bit, too. A graduate of an established program would never question their management skills of sick patients or the lack of experience doing procedures. The exception to this might be orthopedics if you are at a large referral center most of the time in residency, but if you're a good resident you can learn by osmosis helping the ortho residents all the time.

It seems like you went to an (fairly new) HCA residency, am I right? One problem with them is highlighted in your post, the lack of an education standard and general unknowns about what goes on there. It's no secret that HCA prioritizes metrics and appearances (to patients) over a quality physician experience and academics. Are the faculty there really invested in teaching? Do they care enough about the residents to notice if procedure competency is low? Do they notice if you aren't getting enough resuscitations of sick patients? Would they speak up to administration to send you to another site to get those experiences if the existing ones are lackluster? The answer to these questions is "questionable" at best. The Orlando/Tampa/Gainesville area is not NYC, Boston, Chicago, LA, etc. so why do they need more than three established programs (Orlando Health, USF, UF) around there, anyway?

You should've asked yourself these questions prior to ranking this place. I don't mean to be overly harsh, but now is not the time to have these kinds of questions in your training. I'm not saying all new residencies are bad, one which comes to mind over the last few years is Jackson Memorial. They should've had a residency there 30 years ago. On face value you know you're getting a great experience based on the patient population and support of faculty invested in a medical school/university (academic) mentality.
 
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GatorCHOMPions said:
The Orlando/Tampa/Gainesville area is not NYC, Boston, Chicago, LA, etc. so why do they need more than three established programs (Orlando Health, USF, UF) around there, anyway?
Click to expand...

Just to add on to the quoted post above, the population of the three cities in central FL listed above are 285k + 393k + 134k. Ocala where WUBear is apparently a resident has a population of 60k. If we're being generous and assuming Ocala has a catchment area including the neighboring larger cities, the total population it serves is that of 872k. San Francisco, Charlotte, and Indianapolis are cities this large and yet have 1 or 2 EM residencies each.

Back to OP and this place near Houston, at least they serve a population of 2.3M and this would be their third residency. I don't know anything about the Texas market, but it appears people are saying even they do not need another residency there.
 
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GatorCHOMPions said:
Just to add on to the original post, the population of the three cities in central FL listed above are 285k + 393k + 134k. Ocala where WUBear is apparently a resident has a population of 60k. If we're being generous and assuming Ocala has a catchment area including the neighboring larger cities, the total population it serves is that of 872k. San Francisco, Charlotte, and Indianapolis are cities this large and yet have 1 or 2 EM residencies each.

Back to OP and this place near Houston, at least they serve a population of 2.3M and this would be their third residency. I don't know anything about the Texas market, but it appears people are saying even they do not need another residency there.
Click to expand...

That doesn't matter if anything even remotely complex, including trauma, gets shipped by ems somewhere they can handle it.
 
GatorCHOMPions said:
This post scares me a bit, too. A graduate of an established program would never question their management skills of sick patients or the lack of experience doing procedures.

....
now is not the time to have these kinds of questions in your training. I'm not saying all new residencies are bad, one which comes to mind over the last few years is Jackson Memorial. They should've had a residency there 30 years ago. On face value you know you're getting a great experience based on the patient population and support of faculty invested in a medical school/university (academic) mentality.
Click to expand...

I urge you to be a part of the solution, join us at AAEM, figure out representation on ACGME RRC and where your generation went wrong in allowing the spiraling out of control of EM ACGME, rather than just being an internet keyboard warrior on student doctor network doxxing residents asking about the transition to attending. You're not going to fix overcrowding in the EM specialty by chastizing a resident, my guy

Join us in being a part of the solution, not this guy

1589566821332.png


@Zebra Hunter 's post still interests me - I don't see a general EM procedure that a graduating resident would be 'uncomfortable with' (or are you referring to lack of simulation apparent in those residents with procedures like breech delivery, cric, thoracotomy, neonatal resus, resuscitative hysterotomy, etc?)
 
GatorCHOMPions said:
This post scares me a bit, too. A graduate of an established program would never question their management skills of sick patients or the lack of experience doing procedures. The exception to this might be orthopedics if you are at a large referral center most of the time in residency, but if you're a good resident you can learn by osmosis helping the ortho residents all the time.

It seems like you went to an (fairly new) HCA residency, am I right? One problem with them is highlighted in your post, the lack of an education standard and general unknowns about what goes on there. It's no secret that HCA prioritizes metrics and appearances (to patients) over a quality physician experience and academics. Are the faculty there really invested in teaching? Do they care enough about the residents to notice if procedure competency is low? Do they notice if you aren't getting enough resuscitations of sick patients? Would they speak up to administration to send you to another site to get those experiences if the existing ones are lackluster? The answer to these questions is "questionable" at best. The Orlando/Tampa/Gainesville area is not NYC, Boston, Chicago, LA, etc. so why do they need more than three established programs (Orlando Health, USF, UF) around there, anyway?

You should've asked yourself these questions prior to ranking this place. I don't mean to be overly harsh, but now is not the time to have these kinds of questions in your training. I'm not saying all new residencies are bad, one which comes to mind over the last few years is Jackson Memorial. They should've had a residency there 30 years ago. On face value you know you're getting a great experience based on the patient population and support of faculty invested in a medical school/university (academic) mentality.
Click to expand...

Those are strong broad statements of "never question". It's not out of the question to have small doubts as a graduating resident to becoming a new attending especially if they have not had any or sufficient moonlighting experience. I'm a new attending from a 4 year program in Chicago, there have been cases during my first year (about 9 months in) that have made me "uncomfortable". That said, after a full ER residency whether three or four years, it is impossible to see EVERYTHING much less feel comfortable with everything and anything obviously, but you should have a pretty good idea of what something is and more importantly what needs to be done. ETT/lines/chest tubes/LPs/reductions are our bread and butter and we might as well become gas station attendants if you take all of them away.
 
theWUbear said:
I urge you to be a part of the solution, join us at AAEM, figure out representation on ACGME RRC and where your generation went wrong
Quick question, as you seen more in the know than I am. So how much sway does the RRC have in approving/not approving new programs. For example, if there's a new program in Dubuque that has all the requirements covered can the RRC realistically deny approval on the basis of:
1) there's too many programs already and we don't need more ED docs to create oversupply and lower salaries
OR
2) Dubuque is too small and unlikely to have the pathology/volume needed for training
OR
3) this program is run by HCA/USACS/TH and they have been bad actors in the past (assuming you had evidence that they were bad in the past) even though this new Dubuque program looks fine.

Are those legit reasons to deny approval?
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TinkleStinkle said:
Anyone know anything about this program


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Yes. I'm a resident at this program and absolutely love it. It's very welcoming and people all get along really well. The attending's are super nice and we often spend Journal club nights at their homes. PM me if you want to learn more.
 
sylvanthus said:
I think youre missing the big picture.
Click to expand...
At first I completely agreed with you (in my heart I hope I still do). As I reflected further, perhaps we though are the ones missing the future big picture of medicine by nostalgically clinging to our idea of medicine and identity as physicians that is now begotten past in the age of corporate health care.

Budding physicians are goaded into practicing top-notch bundled and metric based care not knowing how to pick up an atypical disease that presents atypically, or how to manage something without an order set, but instead with time and variably adjusting, patient specific care based off of patterns and prior experience.

As I heed my own words, perhaps society has decided that there are just too many people to care about the individual as a physician, instead deciding we want systems to care for the masses. Sounds good in theory, until you’re the patient (or the physician)… reflecting on it all.

If given the chance, I’ll still take the hole in the wall coffee shop over Starbucks (not necessarily always, but go with the analogy). It’s hit or miss at times versus a consistent above average cup of joe, but there is something deeper that can be found when business isn’t pumping out baristas to serve lattes twice as fast for half the cost.
 
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Mount Asclepius said:
At first I completely agreed with you (in my heart I hope I still do). As I reflected further, perhaps we though are the ones missing the future big picture of medicine by nostalgically clinging to our idea of medicine and identity as physicians that is now begotten past in the age of corporate health care.

Budding physicians are goaded into practicing top-notch bundled and metric based care not knowing how to pick up an atypical disease that presents atypically, or how to manage something without an order set, but instead with time and variably adjusting, patient specific care based off of patterns and prior experience.

As I heed my own words, perhaps society has decided that there are just too many people to care about the individual as a physician, instead deciding we want systems to care for the masses. Sounds good in theory, until you’re the patient (or the physician)… reflecting on it all.

If given the chance, I’ll still take the hole in the wall coffee shop over Starbucks (not necessarily always, but go with the analogy). It’s hit or miss at times versus a consistent above average cup of joe, but there is something deeper that can be found when business isn’t pumping out baristas to serve lattes twice as fast for half the cost.
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Go easy on the weed man.
 
Mount Asclepius said:
At first I completely agreed with you (in my heart I hope I still do). As I reflected further, perhaps we though are the ones missing the future big picture of medicine by nostalgically clinging to our idea of medicine and identity as physicians that is now begotten past in the age of corporate health care.

Budding physicians are goaded into practicing top-notch bundled and metric based care not knowing how to pick up an atypical disease that presents atypically, or how to manage something without an order set, but instead with time and variably adjusting, patient specific care based off of patterns and prior experience.

As I heed my own words, perhaps society has decided that there are just too many people to care about the individual as a physician, instead deciding we want systems to care for the masses. Sounds good in theory, until you’re the patient (or the physician)… reflecting on it all.

If given the chance, I’ll still take the hole in the wall coffee shop over Starbucks (not necessarily always, but go with the analogy). It’s hit or miss at times versus a consistent above average cup of joe, but there is something deeper that can be found when business isn’t pumping out baristas to serve lattes twice as fast for half the cost.
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There are too many people with medical problems for the boutique approach of one doctor that has the bandwidth to shepherd you through the system to be practical. In the absence of systems, too many people have no access to care. As physicians in 2022, it's very difficult to look back at the Golden Age of physicians and have any appreciation for how limited in scope they were compared to today and how much simpler things were.
I never got to experience that era (although I heard plenty of stories from the grey hairs when I was training), so it's tough for me to mourn it's loss. What does hurt is how the systems that displaced us have been set-up. If we were replaced by an army of barely trained practitioners following algorithms and people were healthier, that would sting. The sting would be tempered by the fact that society was healthier and there was less suffering and needless disability, patients come first.

But that's not what happened. The most important part of the American healthcare system isn't the patient but the shareholder. Instead of focusing on what's best for the patient (or even what's the most good for the most patients), every level of healthcare above the bedside is focused on maximizing profits. Even the "non-profits" follow the gospel of quarterly earning statements, building up their real estate holdings and endowments until prestige replaces the community's health as the main measure of success.

That's the sticking point for me. It hurts to have gone into monstrous debt to do a job that gets more difficult each year while being paid less. It hurts more to realize the only reason it's setup like that is to make somebody who was already wealthy even richer.
 
sylvanthus said:
I think youre missing the big picture.
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Arcan57 makes a great point about this too but the nostalgia of medicine isnt what it used to be.

I cant speak to other HCA programs but here at Kingwood my experiences have been amazing.
 
DoctorJeffs said:
Arcan57 makes a great point about this too but the nostalgia of medicine isnt what it used to be.

I cant speak to other HCA programs but here at Kingwood my experiences have been amazing.
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Remember that when they keep expanding, flood the market and you have a hard time finding a job. Have the courage of your convictions and dont come here and complain that the market is crap and jobs are scarce in the future.
 
sylvanthus said:
Remember that when they keep expanding, flood the market and you have a hard time finding a job. Have the courage of your convictions and dont come here and complain that the market is crap and jobs are scarce in the future.
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The OP's question was about HCA Kingwood emergency medicine program and how it is there. To that point, it's a great place to learn emergency medicine and critical care. I'd strongly encourage anyone who is interested in EM or becoming a great physician to apply.
 
DoctorJeffs said:
The OP's question was about HCA Kingwood emergency medicine program and how it is there. To that point, it's a great place to learn emergency medicine and critical care. I'd strongly encourage anyone who is interested in EM or becoming a great physician to apply.
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An individual's account of the quality of their program is unreliable, especially when they haven't finished their training. Assuming that you aren't a lateral transfer, HCA Kingwood is your first and only residency program. I'm glad you're having a positive experience, that's much better than the alternative. But until you finish, it's impossible to objectively evaluate the quality of a program that has graduated 0 residents so far.

Kingwood has a pretty big catchment area and is far enough away that it doesn't suffer from the "ship everything remotely complex to the Med Center" but your attendings aren't a who's who of academic EM, per the most recent PDF on your website you're still seeking your level II trauma accreditation, and half of that brochure is about HCA GME in general with a only one paragraph about the hospital and 2/3 of a page about the curriculum which seems to lean heavily on sim labs, problem-based learning (?), and 1:1 airway training with the PD.

None of this means it's a bad place to train, but it's hard to argue that Houston needed another EM residency. Also, there used to be the saying that the RRC doesn't allow bad EM residencies. Unfortunately, the RRC relied on assumptions about who applies for accreditation and HCA figured out that there is a big difference between the spirit of the law and the letter. That's not your fault, but it 's still a big problem for the field.
 
DoctorJeffs said:
The OP's question was about HCA Kingwood emergency medicine program and how it is there. To that point, it's a great place to learn emergency medicine and critical care. I'd strongly encourage anyone who is interested in EM or becoming a great physician to apply.
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See my above post and remmeber it when you graduate.
 
sylvanthus said:
See my above post and remmeber it when you graduate.
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Wasnt this residency the one that was 2/13 full pre scramble. Seemingly students are getting the memo that hca training is a joke and by rule they prioritize service over education. A resident has little insight on how things should be. Very few people graduate and say man my residency sucked. The ones who do are usually the problem and not the program.
in the end hca is a terrible system and it’s hard to imagine that when their gme touts that all these residencies are profitable for them that it’s also a great place to train. I couldn’t imagine hiring someone from one of these places.
 
hundreddaysoff said:
Very nice. Source? Lazygoogle did not find it.
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My guess is the "Confidential- Contains proprietary information. Not intended for external distribution." means it's not going to show up on Google. I'm not casting doubt on Ectopic's work ethic, but it seems unlikely that they got ahold HCA's Powerpoint template, ginned up a fake GME slide, printed it out, crumpled it slightly, then took a picture of it to post here.
 
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