I have to completely disagree with jaydoc... I can only say that this is an individual with clear motive to smite the Jacobi/Montefiore program! Beware advice as purposely negative as Jaydocs!!
I am a past graduate of the Jacobi/Montefiore Program and have to say that J/M has been and continues to be one of the top programs in the area / country. I had rotated as a medical student through various other ED's in the area before ranking Jacobi/Monte #1, did my internship year at another area hospital with an academic EM program and now work at a major academic center. I can tell you 100% that the mis-statements about exposure vs. training, zero faculty input, no protected time... etc. is completely false!
True, you are allowed to make independent clinical decisions as a resident in your more senior years, but this should not be mistaken for a "learn on your own" program. This is one of the few programs I have encountered with a clear and progressive graduation of responsibilities as you move from one year to the next. The faculty is highly involved in daily bedside and didactic teaching as is the chairman of the department, EJ Gallagher, a major academic force in EM, and a resource for the program not to be overlooked. There are times that you feel that you are in over your head, there are times where you are going to read during a shift to teach yourself about a topic and yes, there are attendings that do not teach a hell of alot, but you are not left on your own to make uneducated decisions about patients or to teach yourself about topics. The faculty, is overwhelmingly involved in patient management, bedside teaching and didactics, as are more senior residents who are involved/comitted to teaching as well.
True you do push stretchers around and put in IV's as a resident on a semi-regular basis in order to get the job done, but your job is not reduced to that of a tech. As an attending I continue to push stretchers, put in IV's, dispense meds, get patients cups of water, give patients bedpans, etc. You know why? To get the job done, to be a team player and to be a thoughtful and respectful doc to my patients and others I work with.
As for off service rotations (ICU, PICU) true you do not have direct patient care responsibilities in most cases of off service rotations so your involvement is limited. Some residents do skip out early or do not go at all and why should this be blamed on the program? We're adults folks... we should not have to have big brother looking over us at all times. Don't be misled! The residents are not getting shortchanged... As Jdoc does mention, our graduates know how to take care of realllly sick patients while multi-tasking incredibly high volume... this is a virtue of both training and exposure!
And as for J/M not being a progressive program: how about the fact that in the past five years they have started up two research fellowships (one at each training site) and an emergency ultrasound fellowship (not for cheap labor as Jaydoc may reply, but to further the academics endeavors of the program), hired two directors of research and published numerous articles in major peer reviewed journals (again, not as Jdoc infers for $$- research in general, is not a lucrative endeavor). Residents are also involved in research and present posters/orals at national conferences and are regular co-authors of articles. The program has also moved to a 1-4 format to better standardize the teaching of the residents and to expose them to what J/M feel are key to the practice of EM.
So sorry to Jay doc if he felt that he wasn't spoon fed or hand held enough during his training, but the fact is whether he realizes it or not, is that he graduated from one of the better (not neccessarily the best) programs in the country. He may be surprised to find out that when he graduates, no one is going to push him to read, learn or keep current. Unfortunately for him, if he was not self-driven during his experience at J/M, he never will be as a practicing physician.
True not every resident is going to be happy with the training that they received, but that is not a reason to purposely and harshly condemn a program like he did.
jaydoc said:
Bitter, no... irritated, yes. I would have liked to have had the complete picture before going into residency. I expected Jacobi to be a better teaching program and it simply wasn't. It's a very self-driven, self-taught atmosphere and that can be dangerous. Now, that said, the sheer volume and acuity there was such that you couldn't help but learn. Besides, patients are held there in the ER for hours to days on end, so you end up getting VERY good at managing ICU patients.
I can only imagine that you're talking about Jordan - the red-headed wild child. I'm sure he is a great teacher - he's just a great guy all around. He is also extremely self-driven. I'd say he learned what he learned because of exposure, not training. There's a difference.
Listen, what it boils down to is that you need to know what you're getting yourself into and make sure that is what you want.
