Help! 5 programs and no idea.........

[questionguy]

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So I have narrowed the residency field down to 5 places I like a lot after completing my interviews. I am not geographically limiited/do nto care if I go to a 3 or 4 year program and do not know whether I would prefer a high volume large trauma ED or a more cerbral place with quality bedside teaching. I have been going over and over these 5 programs (with a positive and negative list about each one and I am no closer to deciding). So, since I am looking for alternative ways to figure it all out I thought I'd come here and see what feedback I can get on the following programs.

Here are the 5 in no partiuclar order:

Denver
Bellvue
King's County (really like that they are offering the MPH during residency)
St Lukes (NYC)
Bringham and Women's

Most are NYC (I am from NY), but Boston and Denver are great cities that I would consider living in.


Any help at all in any manner of insight would really help.

 

[hello23]

denver. period

 

[crh3f]

I just did my denver interview yesterday, so I can give you my thoughts on that one. The others are not places I applied...

I thought that the training at Denver would be phenomenal...up there with the best in the country. My only worry about their program was the level of autonomy. For some people, they would thrive in that environment. I think that personally, I need a little bit more hand-holding, a little more of an "ease" into running a department that what they seem to get. Along with this intensity of training, there seemed to be an intensity of personalities...a few of the residents made comments such as "while I personally have never been yelled at...", implying that it happens. While I realize that many programs have personalities that may be more aggressive than others, it made an impression on me that at not a single other place has anyone said anything remotely close to that.

Just a few thoughts...overall, I thought it would be a top notch place to train and come on...it's DENVER!

 

[dlung]

From what the survived-King's County guys I've met have told me, it doesn't sound either "cerebral" or "quality bedside teaching" 😀 Plus, an MPH on top of one of the most notoriously tough residency programs in the country? Sounds masochistic to me, dude. That being said, these guys were the super-studly-est attendings I've worked with... that's right... Not just studly, but superstudly.

I'm having a similar problem sorting my top 5-6 programs... For me, I think it'll basically come down to location and how well did I feel like I fit in with the residents and other interviewees... it's still a big headache and I'm still waffling a lot. 😕

 

[roja]

Of course. 😉


Seriously, you have some fairly different type programs. (at least in NYC).

I did a month at kings county. It was a very difficult decision on ranking them (which I did, but at the very bottom). The faculty there is *outstanding*. the residents are solid. You will get amazing training there. However, it is not from bedside teaching. It is trial by fire. And you will be burned often.


there are no words for how terrible thier ancillary staff can be. It goes beyond wheeling your own patients or drawing bloods. There is a malignant attitude among many of the other employees. There is a huge disregard for the patients by much of the ancillary staff.

The patients are amazing, however. and in general, very very grateful. Excellent pathology. the attendings are very bright.

The residents are worked VERY hard. Thier contracts are spread out over several hospitals so your salary;/benefits change from year to year. You will also have to rotate in places like staten island. You can NOT live in the area. and there is no subsidized housing.

I was veyr torn because I loved the residents, patients and attendings there. However, when it came down to it, the overall atmosphere was ery stressful and depressing. I also knew I wanted to to academics, and probably a fellowship and four years offered a lot less...

Now, why I ranked St. Luke's first:

Great hospitals. county and private, connected by the jitney (aka no commute).
Very academic, in that there is lots of teaching. and you can teach alot.
Residents are VERY happy.
Lots of customized attention. Its easy to find a niche and have it supported and worked on.
outstanding attendings.
very relaxed environment.
EMSTAT
Strong ancillary services.
Busy ED's. (>160,000 visit this year)
Varied patients.
Location
Subsidized housing
Great benefits.



If you have other questions, feel free to PM me.

 

[hello23]

Ok, now I have more time...for denver, I am talking straightly of reputation since basically Rosen, Walls, Wolfe all graduated from there...thus the reputation... BUT, I do know that at Denver, ppl work hard in and out of ED. The resident told me that at other services the 80 hour rule is not always followed. For a 4 year program, it is a very hard working place to train!

 

[Sessamoid]

I know nothing of King's County, but I've just finished a job at a hospital with painful ancillary staff. If the attitude is terribly malignant among the ancillary staff, avoid the place if you can. Nursing and ancillary staff make or break the work experience. If they are lazy and don't care about patients, don't give them or you any respect, no amount of teaching is going to make your time there enjoyable or even tolerable. With poor staff, you'll learn just how little control you actually have in the hospital. You can't perform your own x-rays/CTs, don't have access to meds, even doing your own blood draws doesn't mean the labs will get done anytime soon, etc.

 

[ekydrd]

Denver - snow
NYC - snow

Denver - awesome skiing
NYC - taxi cab surfing

Denver - crime rate not too bad
NYC - well, it's a big city after all

Denver - ummm... the Broncos?
NYC - Jets and Giants

OK, sorry. I realize I'm not helping the decision either. Good luck where ever you go.

 

[Purulent DC]

Hi Question Guy:

I interviewed at two of the programs on your list. My advice:

The burned hand teaches best.

Don't listen to the wussy cry babies, go with Kings County.

 

[questionguy]

Thanks for all of your help so far. A lot of you have brought up many of the positives and negatives about each program that go through my head (location/ancillary staff/pathology/loacation/housing etc) that I cannot seem to tease out and decide upon that 1 perfect fit. I was hoping to walk out of a program with that "gut feeling" I keep hearing so much about that is supposed to tell you where you belong for residency, it didn't happen. 🙁

At any rate, thanks for the feedback, and if your reading please, keep it comming.

 

[ERMudPhud]

I lived and went to school in NYC for a decade and when the time came for me to match I had a similar list. Here are my thoughts.
I chose Denver because I thought at the time it was by far the best for me. I grew up in Colorado and still love it. The training was outstanding and there were a few basic science types in the department I thought would be fun to work with. All of that still applies now but I might have one concern if I were to do it over again. The program now has an integrated first year. While this is good in that it gets you early exposure to EM I thought the first year was a bit heavy on surgical stuff. I was very happy doing my prelim medicine year in NY and was perfectly happy to miss out on any time as a surgical intern.

I think any of the NYC public hospital programs suffer from a real lack of ancillary services. Any time you spend as a resident doing meaningless paperwork, transporting patients, or putting in IV's is a waste. My techs now are better at IV's than I was even after several years working in NYC public hospitals so if they can't get it the patient gets a central line. Despite the lack of ancillary services I have always been very impressed by Bellvue. The Bellvue grads I have met have been without question outstanding and the faculty are some of the best in the world at what they do. I know much less about Kings County but suspect conditions are similar. There are lots of ways to get an MPH so don't go just for that. St. Lukes was still too new when I was applying.

Brigham has access to all the academic resources that come with being part of Harvard. The down side of that is that despite hiring world famous faculty EM has very little power relative to surgery and medicine. As I recall the EM offices were way down in a sub basement which says something about their standing. Despite this, my concern that as EM residents we would be marginalized like med students when off service , and the newness of the program I ranked them second for all the Harvard resources.

If I had it to do over again I would still do Denver, Harvard,then Bellvue.

If you are set on staying in NYC I would say it probably comes down to 3 vs 4 years. If you want 3 go for SLR. If you don't care, take Bellevue. Kings county sounds even harder than Bellevue plus its an outer Bourough and it doesn't have the academic resources of Bellevue.

Just my opinion