King-Drew

[Quimby2]

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Other than the finnancial instability, is the program any good?

Does the lack of other residencies effect the program?
Is the lack of attending coverage really that bad?
Scut-work still a large problem there?
Most importantly, with a little hard work will I know what the hell i am doing by the time i graduate (i.e. is the program really that bad?)

--many thanks all!!!

 

[drpcb]

If you are strongly considering MLK then you owe it to yourself to look at the future of the program and facility. That place is in really dire straits. If the place closes while you are a resident, don't expect anyone to take you on. If you are really desperate for a spot, I suppose it is worth the risk, at least currently, training there will still qualify you with ABEM. The ACGME is so upset with the place, however, that it is not unthinkable that they would make you repeat your entire training, should the place get decertified while you are in training.

 

[Reg]

I have a lot of insight about this particular program right now. They were recently fully reaccredited by the ACGME. The hospital passed JACHO, and it seems like things have settled down a bit. However, I would be concerned about what the future holds with surgery and radiology gone in July. The residents are optimistic, stating that this may mean more surgical procedures in the trauma bay for them, since the PAs and attendings are not going to take procedures from the residents. And, they feel that the radiology department was useless anyway, and are looking forward to reading most of their own films, and having an attending radiologist review them in the morning, or over a pax system. They feel as if their training will be enhanced with less residents to compete with. But I will add that on the interview trail I heard the residents say that, although most love the place, (the schedule is awesome, the moonlighting money is the best) they are concerned about the hospital overall.

The scutwork issue has improved because changes had to be made in order for the hospital and residency to remain open and functioning. The attendings are very nearby, although not necessarily over your shoulder (which most residents there seem to appreciate). And the graduates get jobs without a problem (the residents get jobs 'outside' while still residents, without a problem). They are competent, but of course I've heard stories about one or two who weren't so great as attendings once they graduated. I think they are respected, but the recent events have really taken their toll on the reputation of the institution overall. And, let me add, by far the emergency medicine residents are the strongest residents there. This makes for a positive experience for them and their department. They get whatever they want/need.

I'm not sure I'd rank this place number one next year (because of the hospital issues), but I see no reason (after being here almost 2 months) not to rank it at all. I am concerned about the future of the hospital, but I think the emergency medicine training there is very good as compared to other Southern California programs (which is all I can speak on). And if the hospital is somehow improved, I think this is / or could be a top notch program in the area. I would still choose USC and UCLA over King/Drew (if I didn't mind the extra year). Toss up between King/Drew and Harbor (but I'd lean towards KD because of the schedule and moonlighting). I would choose UC Irvine last. The medical students there call their ER a "glorified urgent care." I guess they don't see as much true emergency stuff as the other programs. But I would rank them all.

 

[drpcb]

last I heard (1 week ago,) the acgme/rrc was threatening decertifying the facility to train ANY residencies. This is in addition to the probation for FP, and decertification of surgery and radiology.

 

[Reg]

last I heard (1 week ago,) the acgme/rrc was threatening decertifying the facility to train ANY residencies. This is in addition to the probation for FP, and decertification of surgery and radiology.

Yep, they were, and still are from what I can gather. This, could potentially affect this year's incoming interns. 😱 If the ACGME decides on their next visit (one year from the last visit) which would be approximately Novemeber 2004, to close all programs, after an appeals process, the final verdict would be issued sometime in the Spring 2005. At that time, the policy is that the accreditation is up effective "not less than" one year from that "final verdict date." That puts us to - Spring 2006. Current residents are allowed to finish the year. So, at the earliest, the effective date would be June 30, 2006. That means CURRENT interns would be finishing up. INCOMING interns could be affected.

This is a concern of mine. I would keep a close eye on the status of the INSTITUTION. The emergency medicine residency program has been fully reaccredited, unfortunately the department doesn't stand alone, and has been very negatively affected by the institution overall.

 

[Reg]

I'm not housestaff, so I don't know all of the ins and outs of the department from a resident point of view. It seems like opinions vary widely depending on the individual resident's experience, I guess. Some residents love the place. The general feeling I get is that most people there like it at first, but over time grow to despise the place. The scut, the ancillary staff, basiclly the COUNTY hospital. Even the attendings seem a bit frustrated at times. And, it seems like the spirit of the place is down - probably because of the recent series of events/press.

Time will be the determining factor for this place. I still feel that overall it's a good program - right now. There's still quite a bit of trauma (more than most places) even with the cut backs. And in the Spring, everyone is envious of the graduating senior class. I will agree, most people wish they were somewhere else - like at a place where things actually WORK. But, that's not to say that the program is bad (or any different) from a typical County hospital.

Do your research, talk to residents, and decide how you learn best. Emergency medicine is competitve, and I wouldn't write off this program.

 

[SewerRat]

Hey Beyond,

Are you still at King-Drew? Did you find that PGY-2 spot to transfer to that you were looking for? I hope you got things settled.

 

[Quimby2]

Suprised to see so many replies after my original post. Well, it is now post-match and I have decided to go to King-Drew. A bit dissappointed to see "Beyond all Hope's" change of heart as, believe it or not, it helped me to decide to rank the program. No regrets as of yet though --I am stoked to get back to So Cal.

My biggest concern I suppose is will I be employable after the residency, or will I be the bastard child of EM. Ask me in three years (if all goes well).

Now I just need to find a place to rent --anybody giving up (or know of) a sweet pad in Long Beach, Seal Beach, Huntington, or Hermosa? (reply to that in the housing post section).

BTW, any of you posters heading there?

 

[farrelli]

Quimby2,
Yeah I matched at King Drew also. Dont have much insight into OC housing. I grew up in LA and am planning on W LA/South bay but Ill let you know of any deals. I am a little supprised by the post though. Im not really sure where they could reroute the trauma to (USC? almost ten miles away). Anyhow, I think well see for sure what ist about in the near future. I had been under the impression things were stabalizing a bit and USC was planning on taking up some of the admin duties. Maybe Beyond all Hope could fill us in a little bit more. I interviewed in January and had read the post and made the decision to rank MLK based on that and the need for me to be in SoCal for family stuff. Let me know what you hear.

 

[Reg]

Every place has those residents who hate it, but talk to lots of people and you'll find some who actually really like it.

 

[Joejitsu]

I thought Dr. Hardin and the rest at Kind Drew did a good job of making the problems sound like they were not as big as most people think. The residents I saw there were mostly aloof except for the one or two that I talked to. The ones I talked to did not seem too concerned about the situation there. I called Dr. Hardin before rank lists were due and had a long follow up talk about the state of the program and he assured me that worst case scenario would still have residents finishing their three years, but again he did not think they would run into big problems. In the end I still had tremendous concerns about the program but ended up ranking them #3 behind Loma Linda and Kern. I matched at Loma Linda, so I don't have to worry about it anymore, but I can't say I would have been disappointed to be at KD (although I would probably have just as much concern as you guys).

And to beyond-all-hope I just wanted to say that I (and I'm sure others) appreciate your candidness regarding the issue. However, I would strongly encourage you to update your scutwork review since that is also a reason I had enough confidence in KD to rank it #3. Even though nobody should rank a program simply based on a scutwork review, with the state of KD program being a huge issue right now your overwhelmingly positive review can have a lot of influence on applicants.

I was surprised to hear you describe the attendings at crimanal and/or incompetent. Would LOVE to hear some stories, but I'm sure you don't feel comfortable talking about that stuff yet. Good luck with the transfer.

Joe

 

[Meza]

Just a few things about survival at King

I find this tread interesting, and wanted to make a couple of points.

*Every* program has issues. Every program has it's politics. Sometimes new residents (interns) are so idealisitc, and think that things should be <gasp> fair. This is not the way of the world (I mean really, think about it). Programs sometimes decide very early on who they like...and who they don't. And if you get on the sh*tlist, it's hard to get off.

I've been a resident in a program that I hated...and hated me. I don't know how I found myself on their sh*tlist, and the topic of all of their "resident updates" at the faculty meetings. But, once I started the program the current residents pulled us (the new kids) aside and gave us the real low down on the program. Who's who, who not to f*ck with, who makes decisions, what lectures are important to attend...etc. I kind of didn't listen because...the program was ass backwards & way below par, and I wanted to "help." My *help* wasn't appreciated (at all) and they proceeded to make my life hell...until I quit. "I'll never quit," you say? <shakes head sympathetically and thinks "silly medical student">.

This is not atypical. And when I hear stories about residents quitting, transfering, or getting fired...and it's not academic...I think to myself "someone should have told him/her how to navigate the program before it got to that point." You'll usually find residents that really like it...that really hate it (on the sh*tlist) and most who just try to remain clandestine. Those who don't hate the program, but know (and adheres to)the "rules." Sometimes these rules are easy...and sometimes they violate your very core. Decisions are sometimes very though.

I'm sure Beyond all hope's experience with King-Drew is very real, and could happen to anyone. But, trust me, it happens way more frequently (at programs all over, not just King-Drew) than MS4's (and new interns) are likely to believe. Also, the "grass is always greener..." You don't know what other programs are like, and no one tells you the internal conflicts until you are "on the team." Interns frequently fantisize about "other programs" as if the same s*it isn't happening there. And you don't know, until you know. True, there are some programs that are better than others in this area, but my point is, you could very well find yourself "in trouble" at an excellent program, and come to hate it over time. It can happen. This is what probably happened to Beyond all hope...and it's not unusual.

When you start your residencies (internships), my word of advice....stay below the radar, listen to those who are there, get a feel for the program, see who's who, see how things are done, don't piss off anyone, and work hard. After 6 months the internal politics of the department will be more apparent to you...then you'll know how to proceed. Now, to this I can say...you've been warned!!

 

[mountebank]

this is a great post describing the "dark" side of residency. For the students out there, the problems that are being stated here are those that you should inquire about during the interview trail. Another reason why one should do a "second look" at their top 3 spots.

 

[farrelli]

I actually am not upset to be going to King-Drew even under the present circumstances. The current health care system is in the toilet and MLK is just the perfect example. South LA has little to no access to primary care clinics as private family practice offices are non exsistent and the University's family practice program is currently having a sustained run of SVT 😱 That leaves the ED is virtually the only access to care for a many members of the population. I do not live under the mistaken impression that as a resident I can do much except see patient after patient and hope that someone brighter and much more well connected than me comes up with a solution. It is however, the group of people I set out to practice medicine for. Residents of Sherman Oaks/Santa Monica/W. Hollywood etc. are not in need of more physicians while south central LA is. The amount of patient interaction, numbers and acuity will ensure that there will be little that I will not be ready for after residency. My only concern by earlier the earlier posts is that they may be attempting to reroute critical/trauma to other hospitals which I think is both bad for the area and the physicians in training. A situation like that is what sparked the Watts riots in the 60s and led to the construction of King/Drew. It would seem to me that it would be extremely shortsighted to close MLK and open up the same can of worms that they have delt with in the past. I think it is much more likely that reform will be on the way in the way of administration change/ staff change etc. Regardless, we will see in the near future. I look forward to starting even with the current turmoil. Hopefully the idealistic side of me will survive although I have no doubt that I may be overwhelmed at times. In the end its all about the training. You deal with crap from people every day. Why would residency be any different. Ill soon see for my self.

 

[The White Coat Investor]

The amount of patient interaction, numbers and acuity will ensure that there will be little that I will not be ready for after residency.

Where does this idea come from that learning to practice medicine in a county facility somehow makes you "able to do anything in EM." I have been underwhelmed with the people skills of some of the attendings I see coming out of county programs. Granted, my n is very small, but I think there are a few things learned about practicing emergency medicine that aren't learned in a huge, inefficient hospital where none of the patients pay their bills, none of the patients have follow-up, and a low percentage of patients have the capacity to find their way out of the social hole they find themselves in. Not to slam on counties, but I think I've learned a lot of useful skills at community and university hospitals that I probably wouldn't have picked up at a county.

 

[farrelli]

I am sorry if my post was read to be derogatory of university or private EDs. Quite the contrary I think that they are great sources of learning. I was not trying to open up a discussion on privitization of medicine vs. public medicine. You are speaking to the choir when you say that county programs can be a model of inefficiency. I simply was speaking about my motivations for practicing medicine and the people I would choose to treat. Not everybody elses. Everbody learns better in different environments and practices medicine for different reasons. Anyway, that being said I wish you luck and hope that one day I wont be one of the county trained physicians that you will be underimpressed with. I feel pretty confident that I wont. 👍

 

[Quimby2]

Just an interesting point or two from the last couple posts:

1) Seems like a fairly homogenous residency like EM at King-Drew could use a couple months of out rotations at a suburban ED to increase the diversity of education. A good model might be the one that exists at Maricopa County(phoenix, AZ) which includes two months of an out roation in Scottsdale (suburbia).

2) Which leads me to the sedcond point: I probably should not be the one to try and change the schedule at KD --just do it as an elective if I feel it would be beneficial.

After reading how this thread has evolved over the last couple weeks, I still find myself stoked to wind up at KD. I suppose it's about realistic expectations and knowing what's up ahead of time --thnx Beyond. 👍

 

[The White Coat Investor]

I am sorry if my post was read to be derogatory of university or private EDs. QUOTE]

Not jumping on you, it's just a sentiment that I seem to hear frequently which seems to be based on something I haven't yet seemed to "get." Maybe I'll start my own thread on it and see what people think.

 

[Sessamoid]

I was surprised to hear you describe the attendings at crimanal and/or incompetent. Would LOVE to hear some stories, but I'm sure you don't feel comfortable talking about that stuff yet. Good luck with the transfer.

Joe

I'm sure there's more behind the scenes, but here in LA all you have to do is keep an eye on the newspapers.

 

[Quimby2]

Sessamoid, where did you do your EM residency? Done now?

 

[Sessamoid]

Sessamoid, where did you do your EM residency? Done now?

Texas Tech, in lovely El Paso. Been done for a few years now.

 

[Quimby2]

Just out of curiosity, and of course bearing in mind each individual has their own abilities, have you worked with any KD EM grads? They seem adept?

El Paso for three years. Your a bigger man than most.

 

[Sessamoid]

Just out of curiosity, and of course bearing in mind each individual has their own abilities, have you worked with any KD EM grads? They seem adept?

Actually, my medical director is a King grad. Pretty sharp. Doesn't seem to get ruffled easily, if ever.