Martin Luther King Hosptial Jr-Drew (CA)

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SexyEgptnDr

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Is anyone rotating or doing their residency through this hospital? If so, can you PM me? I have tons of questions.

Thanks!

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I cut and paste this 7/24/03 review of Drew/MLK on Scutwork for you. The guy who wrote it was open to questions so you have an option to email him (nick=INTERN).

Schedule

Schedule is fantastic. ER rotations are 2 days on (12 hr shifts, which often extend to 13-14 hrs), 2 days off meaning you get two weekends every week!

The tough offservice rotations (CCU, ICU, Trauma, Neurosurg, Ortho, OB-GYN) have 80 hrs/week schedules, Q3-5, but are very managable. The easy ones (NICU, Anesthesia, Psych, Derm, etc) are very easy schedules.

Teaching

The clinical experience at MLK-Drew is incredible. You treat extremely sick patients with end-stage pathologies, and frequently you do so by yourself. Juniors (2nd year) run the critical areas, which are mini-ICUs within the ED. Because the wait for ICU beds can be hours, even days, they really run like ICUs. We see kids in the ER, many of whom are very sick, so you have plenty of pediatric experience, and it's one of the busiest trauma centers in the country. The military sends it's docs to us to get trauma training. We are an ambulance base station, so you get experience taking ambulance calls and running the base stations all three years. The ER residents are top notch. We score in the top 5-10% in the country on inservice exams every year. Indepedence is not only encouraged, it is required. Even interns often have responsibility for half of the entire floor, as the seniors and faculty have other responsibilities that take them away from the ER. I would take an MLK senior or even a junior over many attendings who trained at less demanding programs. Procedures are numerous. You can intubate and do central lines to your heart's content. Thoracotomties, chest tubes, venous cutdowns, floating pacemakers, you name it, we do it on a daily basis. The lectures (7 hrs/week) are touch and go. Many professors simply read from their slides. Yuck. Some are great, though. The attendings are extremely varied in their approach to patients and residents. Some offer teaching on every case, some wait to be asked questions. Research is not really strong here, but it is getting better.

Atmosphere

The hospital is a county hospital. The facilities are outdated, the staffing is tight. The ER is small and many of the patients smell really bad. Many of the ancillary personel are incompetant, and many have serious attitude problems. Some simply don't give a **** about you or your patients. Patients frequently wait over 24 hours to get admitted. If you want something done at King/Drew, you do it yourself. Drawing blood, wheeling patients to X-ray, you name it, for all three years. If you are squeamish about dirty people or doing your own scut, don't come to county. Some people worry about safety. King-Drew is very safe to work at. We're two blocks from the freeway, so you're not driving around Compton. You almost never leave the hospital later than 8 or 9 pm anyway. The whole hospital is teeming with guards, and even the gang bangers are cool and respectful when on the grounds. The ER residents are very cool, and we socialize with each other inside and outside the hospital. Some of the ER residents put down other specialities in the hospital (medicine, surgery) but I have found many of them to be very friendly and excellent physicians, with a few notable exceptions. It's a great atmosphere, because we do so many off-service rotations we know all the residents and the attendings in the hospital very well. The patients are extremely poor, extremely sick, and usually very grateful and appreciative of your help. About 40% black, 40% hispanic and 20% other. Speaking Spanish is very helpful here. You do get a few drug-seekers and obnoxious folks, but they are really the minority. Most are nice people who really need your help. There are close to 100% FMGs in the other specialties in the hospital, but the ER program is almost 100% US MDs. Do you have a life outside work? Heck yeah. I hit the beach several times a week, even when doing 80 hrs in the hospital. Most of us live in South Bay close to the beach, and MLK is a 20 minute commute with almost no traffic. Drug reps take us to fancy restaurants several times a month. I've never eaten so good. Don't forget moonlighting. You are allowed to moonlight as soon as you get your liscence, starting in-house second year in Urgent Care and Neurosurg and outside in your third year. Some residents make six figures in their second year! By third year many make almost attending salaries.

Conclusion

In conclusion, King-Drew is a top-notch clinical program with a fantastic schedule. The atmosphere between residents is very friendly. You can gain money and confidence moonlighting with plenty of time left to read, hit the waves or do whatever else you'd like. On the down side, research opportunties are limited and the ancillary services are the worst I've ever seen. Scut-o-rama. However, I interviewed at great programs all over the country (Jacobi, Columbia-Cornell, U of Chicago, USC, etc), but chose MLK simply because I knew after three years I'll have the skills, knowledge and confidence to handle any emergency. If I had to redo my rank list, I would rank it number one without reservation. (I've only been here a month, though, so much of what I've written is heresay. Take it with a grain of salt.)
 
There a few other threads from the past several months that you can get by using the search function in the top right corner.

Just type in "King Drew" and restrict it to the EM forum.
 
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MLK's surgical residency just lost their accreditation summarily, meaning their residents had to stop immediately and go elsewhere. The ER is not receiving Peds trauma as of about 1 month ago, and I cannot see how it would be humanly possible to staff their trauma service without the residents. Their radiology residency has been cancelled, and anesthesia and neonatology are in jeopardy. The county has the option to end their contract with MLK based on these digressions, in which case the EM residency would no longer exist, even though the EM residency is not currently on probation.

Therefore, their present situation is an ED that is not a level 1 trauma center, and this is the best case scenario. In the worst case scenario, they will be closed entirely. This is a rapidly evolving situation and anyone considering applying to MLK ED must be VERY familiar with this.
 
Why are the surgery and radiology programs being shut down and why are the other programs in jeopardy?

I read elsewhere that the hospital has been having problems with getting adequate funding from the city government for some time. Is it related to that?
 
THE STATE
King/Drew Loses Its Right to Train Surgeons
August 23, 2003

Los Angeles Times Headlines

MARTIN LUTHER KING JR DREW MEDICAL CENTER

ACCREDITATION

THE STATE

HOSPITALS

MARTIN LUTHER KING JR DREW MEDICAL CENTER HOSPITAL


By Tracy Weber and Charles Ornstein, Los Angeles Times Staff Writers


Martin Luther King Jr./Drew Medical Center has been stripped of its accreditation to teach general surgeons, jeopardizing its entire physician training program and potentially impairing the hospital's ability to operate on patients.

The rare move this month by the Accreditation Council for Graduate Medical Education, which cannot be appealed, is a devastating loss for the Compton-area public hospital, which relies heavily on medical residents to care for its mostly poor and uninsured patients.

The hospital was created in 1972 in response to concerns that the community, then mostly African American, did not have access to adequate medical care.

The decision comes as several of the hospital's major teaching programs are imperiled. Less than a year ago, the council revoked King/Drew's right to train diagnostic radiology residents, which takes effect next June.

In addition, four more of King/Drew's 18 training programs are on shaky ground with the accrediting body. The hospital's anesthesiology, family medicine, internal medicine and neonatal-perinatal programs have been placed on probation or have received warnings in the last two years.

The surgery program sanction, known as "summary withdrawal," is given only under extreme circumstances ? two other times nationwide this year and never in the previous two.

The decision, which takes effect immediately, means that King/Drew must now find surgical training programs at other universities for two dozen residents, including six who just began their training this summer. Residents slated to complete the five-year program by next June can stay.

In general, residents are new doctors being trained in a specialty; to be certified in that field, they must complete an accredited program.

The accrediting council revoked the surgery program's accreditation because it had two more residents than the 38 it was allowed, county officials said. The program was placed on probation last year because residents were not provided with enough surgical experience, faculty research was inadequate and curriculum did not follow recommended guidelines.

Officials at Charles R. Drew University of Medicine and Science, the historically black college that runs the hospital's training programs, said they understand their punishment because they broke the rules.

"The rules are the rules," said Dr. M. Alfred Haynes, chairman of Drew's board of directors. Still, he said, "This is a severe blow."

The accrediting council plans to visit King/Drew for a review of its overall physician training programs Sept. 9. The institution received an unfavorable rating overall during its last review, in 2000. If it receives another unfavorable rating, the council could pull its right to train residents at all.

News of the medical center's loss came as a shock to former surgical residents. Officials at Drew broke the news to faculty and residents at an evening meeting Friday.

"It's going to be devastating not only to the hospital, but to the community, because the residents do all the work there," said Dr. Romeo Massoud, a trauma surgeon in Georgia who completed King/Drew's general surgery residency in 2001. "Where will the people go? Where will they go? There's just going to be too much work."

As surgical residents left the meeting announcing the program's shutdown, some looked as if they had been crying; others appeared angry and were unwilling to answer questions.

"It's an outstanding program," said Dr. Michael Sedrak, a resident. "This is an unfortunate decision."

King/Drew is one of 13 centers in Los Angeles County certified to handle trauma, including gunshot wounds and car-accident injuries.

The loss of the residency program will force the county to downgrade the hospital's official status, but the facility will still be certified to treat the same kind of patients. The problem, however, could be staffing the trauma center, where residents play a key role.

Combined, the loss of the surgery and radiology programs allows Los Angeles County, which owns the hospital, to terminate its $13.8-million agreement with Drew. As part of that contract, the loss of two programs "shall constitute a breach by [the] university and an event of immediate termination of the agreement."

But Dr. Thomas Garthwaite, director of the county Department of Health Services, said he doesn't intend to end the relationship immediately, because the new leadership at Drew has been working hard to improve the residency programs. Garthwaite and the medical school dean, Dr. Marcelle Willock, have been in their positions for less than two years.

"We fully recognize that there are several programs down there that have been on the margins, but we've taken fairly decisive action" to make changes, Garthwaite said. "It's still too early to tell whether the efforts of the new leadership at Drew and the Department of Health Services can be successful or not."

Garthwaite said he had already relieved Dr. Arthur Fleming, chairman of the general surgery department, of his administrative responsibilities and would conduct a national search for a new chairman from outside King/Drew. Fleming will remain on staff as a physician.

The county health department would not release correspondence from the accrediting council outlining the penalty, citing the need to keep such information confidential.

Drew board Chairman Haynes said Fleming's efforts to help out some struggling doctors by allowing them to stay in the program an extra year may have gotten King/Drew in trouble.

"I do know that Dr. Fleming is a very compassionate individual and he may have been trying to bend over backward."

Haynes conceded that the surgery program is "not as good as it can be." The program's pass rates for the surgery board exams were brought down recently after two surgeons who were clearly unprepared took the boards and failed, he said.

In 2002, only one of the four residents who took the written test passed. The pass rate was much higher ? above 80% ? the previous four years.

King/Drew can apply immediately to start a new surgical program, but the institution would have to prove that all of its problems had been resolved, and approval is not guaranteed.

"I can't imagine that we would not eventually reapply," said Dr. Charles Francis, president of Drew, who did not specify when. "Surgery is a major program and one which we obviously want to have as strong here as possible."

Haynes said it could be difficult to attract residents to a new surgery program because the reputation of the institution has been damaged.

Officials at other public hospitals around the country said the loss of accreditation for a surgery training program would have serious consequences.

"It would be extremely difficult and extremely expensive" to continue operating without a surgery residency program, said Michael Korpiel, senior vice president for surgery and trauma at Parkland Health and Hospital System in Dallas. "That would be pretty devastating. We wouldn't be able to do it. We wouldn't be able to survive. I don't know how they're going to do it."

Without residents, a hospital would have to hire staff surgeons who would have to be paid substantially more than trainees.


"I don't how they will substitute for the absence of the residents," said Dr. Gabriel Carabello, who completed his surgical residency at the hospital and later served on staff. "There is a high volume of patients there and the residents are key to delivering patient care."

Carabello, who is now a vascular surgeon in Glendale, said King/Drew's surgical training program is excellent.

If necessary, Francis said, his surgical faculty would step up and fill the void left by the departing residents.

"Most people agree that there is going to have to be some adjustment, but I don't know that we've had enough time to quantify that right now."

County Supervisor Yvonne Brathwaite Burke, whose district includes the hospital, called the violation by the surgery program "unthinkable" and said she has summoned the president of Drew, the dean of its medical school, the director of the county health department and members of the Drew board to her office Monday to discuss the situation.

"It seems to me the board of that school should have known about it and they should not have allowed this to happen," Burke said. "The only way my trust will be restored in the institution is when I see that they are getting the proper accreditations."

Drew board member Marvin Jubas, a lawyer, said that because the hospital has been underfunded, negative repercussions can be expected.

"It's pretty easy for somebody to sit back and say, 'This is outrageous. It shouldn't happen,' and then look for the fall guy ? who should take the blame for what took place. If politicians want to try to look for blame, there's plenty of blame on their doorstep. You can do just so much when you are significantly underfunded."


"The threat to the university is enormous," he said. "Not only do you have the concomitant loss of credibility that goes with it, [but] it's very easy to say, 'They're not doing a good job. Screw it, let's kill the program.' "



--------------------------------------------------------------------------------
Times staff writer Monte Morin contributed to this report.
 
HI,

I go to med school in LA. I have not had any personal experience at the Drew-MLK program. However, I have been told by several faculty that "you can will get good training from any program in southern california, except for MLK". Take it for what it's worth. I am not going to apply there.

Jeff
 
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Before making a decision not to apply, decide what level of supervision you require. If you require a lot, Drew is probably not for you. It may be ok for someone who is more comfortable with independent learning who wants to live in L.A though.
 
Before making a decision not to apply, decide what level of supervision you require. If you require a lot, Drew is probably not for you. It may be ok for someone who is more comfortable with independent learning who wants to live in L.A though.

The problem with this mindset is, “ You don’t know what you don’t know.” Easy way to really fk someone up especially in the acute settings.
 
And this person had to click the button saying that their response probably won't add anything. And, it's true!

Ha.

I will give them that "door to balloon knot" is a pretty great name tho.
 
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