King/Drew Update

[Apexdigital]

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I was part of the soap opera fiasco at King-Drew, via being an EM resident there.. For obvious reasons I will keep myself anonymous; however, I give props to Jon for being openly vocal.

There is enough material to write a book, even a movie on the MLK EM residency itself with the surrounding havoc around it. The EM dept. itself has all the complex personalities between residents, attending(s), to radiology techs, to clerks on and on.

I haven’t read Jon’s article, but hope to read it soon.

In all honesty, being away from King five months now, I miss the ED there. As cheesy as it sounds, it was relatively magical. It had it’s own unique personality and even with it’s less than stellar attendings, the ED dept was like the little train that could. It had managed to encase itself, like a lively seed protected from it’s surrounding. For the amount of independence and the level of acuity, residents ran a good show.

I myself was surprised by the competent care rendered in the ED amist the sickest and poorest patients. It wasn’t fun working with the world watching over you, but the ED dept and it’s residents chugged along steaming here and there and letting out a thick whisle at the end of the shift, but at days end, the ED at king had saved a life or two, had stopped the pain of more than a dozen people, and had directed others to appropriate specialists whilst the L.A. times without an ounce of mercy pounded and pounded at the hospital, and in the end, even at the ED residents.

When we were literally thrown out, none of the California residencies wanted to get their “hands dirty“. One thing I disagree with Jon, from reading his posts here, is that it seems he puts the complete blame on the county, which, yes, they put resistance to one program that kinda peeked their head and kinda wanted to help, but I was disappointed with how none of the California programs tried to help.

Email after email from resident after resident to programs across California went literally unanswered.

Another thing I disagree with Jon, is the possible use of race/gender in picking cheif residents. In-service exam scores were used heavily in choosing chief residents. So how is that using racial/gender preferences? If anything, residents that hauled their butts were disportionately picked as chiefs. One of the chiefs this year was a hispanic guy, and he was amazing clincially. One of the smartest people I ever met.

Another subject I want to touch on, which I heard about only a day before taking the inservice exam, was accusations of using previous questions to study. Bottomline, that was news to me. I never heard of any of my fellow residents using previous questions and no one ever offered me any such previous questions. At the point when this came down, I just didnt' care that they almost didnt' let us take the test. I was tired, I had given up. I wasn't gonna put up a fight. They year had taken it's toll. But with my number two pencil, I sat there and took out my anger on the test, I think I knew the answer to every question. Maybe they'll contact me soon and accuse me of cheating?

Everyone was placed, and hey, sometimes things happen for a reason. I hope I find that reason soon.

 

[Reg]

Apexdigital, I think many former residents feel as you do. I have friends who were residents there, and this entire ordeal has left them reeling. Eventhough a few have been out for over 4 years.

I recall one resident who sent out a mass email to the other ER programs in the area, basically stating what you just said (but harsher). Those programs that are "glorified urgent care clinics" passing judgement on those doing 'war medicine' with no support.

USC seems to be self-assured enough to not care what people think of them. I got the sense they were willing to take some residents without fear of "getting too dirty." Afterall, they are USC...they can not be made dirty. But some of the other, weaker, programs...in the typical passive aggressive style consistent with insecure, weaker, entities...they over-inflated their own strength, and in the process feel the need to berate others (that are probably, in fact, stronger).

King/Drew was in a precarious situation. And it was this situation that made for great ER training initially. Imagine, working in South Central, Level I trauma, base station, PCCC, with mostly incompetent support staff. You see a lot, and do more. I'd say, after doing rotations at both USC and King/Drew, the experience you get from King/Drew was just a bit better when it came to the very sick/critical patients.....because....there was no one else to call. There was no surgery resident taking the procedure...or an OB resident doing the crash, perimortum c-section. There was no strong pediatric presence to take control of a BOA, or pedi resus. No ENT or anesthesia to do a difficult intubation. At USC, because of the strength of their other services, the EM residents, actually did....less (and had to fight for more).

I miss my time at both USC and KDMC. They were alot alike. I know my friends talk fondly of their time at KDMC (moreso than my friends at USC). I got the sense of "we're in it together" from the King Drew residents. Like survivors of war.

I also agree, I don't see that there was any race/gender preferences given regarding chief resident selection. At the *hospital* (the CEO, and high admin positions), I see that there was a preference for AA males (at least in the past). And when the time came to 'replace' them...there were the expected cries of racism (which wasn't applicable in this setting considering the total incompetence of the place). People across the board were promoted to incompetence. The nursing was horrific with SEIU holding no one accountable. And on...and on....

But in the ED program, things were....better, as you said. Insulated, protected, functional. Until there was noone left, nothing else to attack. And even still, the patients came, were treated, under the microscope of the Los Angeles Times...and the entire State. Every mistake, magnified. Every bad outcome was now someone's fault (even when it was no one's fault). The few attendings that tried to teach, and basically do right, couldn't. The politics overwhelming.

A great program, King/Drew was. And the residents competent and clinically astute. It's such a shame that healthcare overall, just sucks so bad. This is not an isolated event, the closure of this hospital. But it is unfortnuate that this community...and these residents...seemed to have suffered the most.

 

[Quimby2]

Does anyone have a link or copy of the article by McGarry? --my PD wanted to read it and I think that the EMRA web site for "EM Resident" has not archived the current issue yet.