New EM Residency - Corinth, MS

[Groove]

Faculty Member of the Month | Emergency Medicine Residency

Can you guess who the Magnolia Regional Health Center Faculty Member o fthe Month is for September? Visit our website to find out who won!

www.mrhc.org

The prevalence and frequency of these new programs at subpar locations is getting ridiculous. I heard about this incoming new residency from a phone call with a CMG Sr. recruiter whom I've known for years and was discussing jobs and regional EM related news. I'm very familiar with this state and this region and I can't fathom why on earth someone would think to start an EM residency at this hospital of all places. This is not a slight against the newly hired dept chair...I know him personally and I like him. That being said, here are the stats:

Magnolia Regional is only a level III trauma center with 200 beds in the entire hospital. The ED sees only 33K pt's a year. The ED has only 25 beds! It's in Corinth, MS! The population is like...14K.

I mean, c'mon...why don't we just start a new EM residency at a FSED while we're at it. How do these things get approved? Yet another incoming residency at a ridiculous location that will only flood the market with even more grads. I wouldn't even be that upset if I had confidence that the residents would be well trained but this is a terrible location! They would have to be farmed out to NMMC in Tupelo, MS (75K, Level II, might as well be level I) huge hospital, to get any real training and exposure to quality pathology and medical subspecialties. I doubt that would even happen as I heard NMMC has a new FM EM fellowship. So, I have no idea where they would rotate other than MRHC. Crazy.

---

Members don't see this ad.

 

[alphaholic06]

They'll probably rotate in Jackson and Memphis.

 

[Groove]

They'll probably rotate in Jackson and Memphis.

Where? There's already a residency at UMMC and it's the only level 1 trauma center in the state. Where else would they rotate to get any quality exposure? They can't rotate at ROH in Memphis because the UT MUH EM residents already rotate there. There's no other designated trauma center in Memphis. Sure, they could rotate at LeBonheur for Peds, etc.. but you're talking a 4h drive to Jackson, MS and a 1.5-2h drive to Memphis, TN. It just begs the question why on earth you'd pick Corinth, MS of all places.

 

[CajunMedic]

They were the backup, to the backup, to the backup plan if I hadn’t matched or SOAPed successfully this year and they had gotten accreditation.
I spent the day with the aPD and had a conference call with the PD.

As I understood it,they were looking at LeBonehur for peds. At the time, they were talking to Huntsville Hospital (88 bed ED And level 1) in Alabama for Trauma and maybe others since It’s 2 hours away and closer than Jackson They’re also slated to do shifts at the on-site urgent care basically to run a mini-ed and supervise mid-levels.

UMMC probably isn’t out of the realm of possibility for Trauma or PICU. The EM residents where I did my TRI do Trauma/Peds Trauma/PICU already at UMMC.

 

[GonnaBeADoc2222]

There really is no limit to this is there.

Seems like anyone can open an em residency in 2019.

I think I'm gonna open my own. Trauma will be on the streets of South Chicago. Peds is at the local toys r us. Conference is in my basement every Wednesday. EMR is Microsoft word

 

[GonnaBeADoc2222]

Lolz at 33k volume level 3

My residency had a couple sites each with 100k volume

 

[carbonizedeyesockets]

I can't remember if it was shared here, but there was a study showing that residents save a hospital money compared to MLPs. These decisions are purely financial. it's not just CMGs doing this. Non-profit health systems are getting into it too. It's only going to get worse unless the ACGME changes their standards, which seems highly unlikely.

 

[VA Hopeful Dr]

Lolz at 33k volume level 3

My residency had a couple sites each with 100k volume

My unopposed FP residency hospital's ED in 2015 had 98k visits and is a level 2 trauma center, no EM residency because of course there isn't

 

[VA Hopeful Dr]

I can't remember if it was shared here, but there was a study showing that residents save a hospital money compared to MLPs. These decisions are purely financial. it's not just CMGs doing this. Non-profit health systems are getting into it too. It's only going to get worse unless the ACGME changes their standards, which seems highly unlikely.

Is there significant expansion outside of FM and EM in non-academic hospitals?

 

[alpinism]

This is essentially an urgent care residency.

I'd be very hesitant to hire any of their graduates.

 

[Buckeye1992]

My residency has a similar setup actually. Level 3 trauma 39k volume 205 beds. We are pretty high acuity though and admit almost 30%. We also have a FSED that is 30k annual volume. We do ok. We spend multiple months at a lvl 1 trauma though and multiple months at ped hospitals away from our hospital which sucks.

It can be done though. Most ED jobs are going to be at similar places.

 

[KGflyboy]

This needs to stop. Why is this a thing? I expect this sorry of thing out of HCA. I think non-HCA hospitals are noticing how easy it is to start a residency and get cheap labor, so more and more hospitals will attempt this.

ACGME should be above this. It's out of control.

 

[EctopicFetus]

My residency has a similar setup actually. Level 3 trauma 39k volume 205 beds. We are pretty high acuity though and admit almost 30%. We also have a FSED that is 30k annual volume. We do ok. We spend multiple months at a lvl 1 trauma though and multiple months at ped hospitals away from our hospital which sucks.

It can be done though. Most ED jobs are going to be at similar places.

Do you think a 30% admit rate is high? Not trying to be a prick but it is not. The overall quality of this is poor. Residents get a subpar experience traveling all over working with attendings they dont know.

My group has 3 sites. One of which has about a 50% admit rate. The others are lower-ish acuity and admit percentage is well above 30%.

Admit rates at 20% or so are a joke and barely more than UCs. It saddens me we have such jokes of residencies. Someone will hire you but you wont be in line for a decent job.

 

[Buckeye1992]

I would say ED volume is just one thing to look at. You can’t just say all residencies that see less than 100k or admit less that 50% are poor.

Obviously pathology, acuity, out rotations, staffing, educational resources, attendings, etc all play a role.

 

[EctopicFetus]

I would say ED volume is just one thing to look at. You can’t just say all residencies that see less than 100k or admit less that 50% are poor.

Obviously pathology, acuity, out rotations, staffing, educational resources, attendings, etc all play a role.

With low volume and low acuity you cant learn crap. Also, I don’t think corinth Mississippi is real high on where top notch ed docs want to live. I could go on.

 

[Rekt]

I would say ED volume is just one thing to look at. You can’t just say all residencies that see less than 100k or admit less that 50% are poor.

Obviously pathology, acuity, out rotations, staffing, educational resources, attendings, etc all play a role.

This is debated quite often and I strongly disagree. I think volume is quite important. More patients = more exposure = more pathology = more presentations, etc. It seems hard to argue against this. My program is very high volume and often the attendings will take one for the team seeing the low-yield stuff like EtOH/SI and give us the good stuff along with procedures because there's plenty to go around.

 

[carbonizedeyesockets]

Is there significant expansion outside of FM and EM in non-academic hospitals?

Not sure. I know that where I'm at, they're definitely adding FM and IM. Radiology, neurosurgery, and a few others were being discussed.

Do you think a 30% admit rate is high? Not trying to be a prick but it is not. The overall quality of this is poor. Residents get a subpar experience traveling all over working with attendings they dont know.

My group has 3 sites. One of which has about a 50% admit rate. The others are lower-ish acuity and admit percentage is well above 30%.

Admit rates at 20% or so are a joke and barely more than UCs. It saddens me we have such jokes of residencies. Someone will hire you but you wont be in line for a decent job.

National average for admission rate is <10% for all visits, per the CDC. I trained at a place with pretty good acuity. It was about 28% for 2 hospitals combined (~134,000 visits). One hospital I'm at now has ~95k visits and an admit rate around 20-25%. According to SAEM, some of the busiest county places aren't hitting 30% admission rates.

If your place has a 50% admit rate, then you're an out-lier.

 

[deleted436726]

lol @ all the drama here. Look at it this way, from the perspective of a fresh-faced PGY-1 TY intern like me who's only doing a TY because they failed to match EM last year and is so crazy about doing EM that they would rather quit medicine if they couldn't. I'm from the Midwest, I have no ties to bum**** Mississippi (did I spell that right?), but if given the chance to do EM here versus the alternative, would I take it? Hells yeah.

 

[GonnaBeADoc2222]

lol @ all the drama here. Look at it this way, from the perspective of a fresh-faced PGY-1 TY intern like me who's only doing a TY because they failed to match EM last year and is so crazy about doing EM that they would rather quit medicine if they couldn't. I'm from the Midwest, I have no ties to bum**** Mississippi (did I spell that right?), but if given the chance to do EM here versus the alternative, would I take it? Hells yeah.

It's just so weird that you would rather quit entirely if you couldn't do EM.

 

[hoot504]

lol @ all the drama here. Look at it this way, from the perspective of a fresh-faced PGY-1 TY intern like me who's only doing a TY because they failed to match EM last year and is so crazy about doing EM that they would rather quit medicine if they couldn't. I'm from the Midwest, I have no ties to bum**** Mississippi (did I spell that right?), but if given the chance to do EM here versus the alternative, would I take it? Hells yeah.

No @!*# sherlock. It isn't news that a desperate medical student might take a chance on one of these programs.

Do you think Dermatology would improve as a specialty if those who failed to match every year were allowed to train at some newly established residency in West BFE? No.

 

[scoopdaboop]

What’s the thought logic for opening these new em residencies? Em isn’t really primary care and filling a shortage of primary care docs sure isn’t the argument

 

[Dr Mantis Toboggan]

Yeah that’s the crazy part. You never see Derm or Urology doing this. Maybe they have more structural research requirements or something.

No @!*# sherlock. It isn't news that a desperate medical student might take a chance on one of these programs.

Do you think Dermatology would improve as a specialty if those who failed to match every year were allowed to train at some newly established residency in West BFE? No.

 

[TooMuchResearch]

Money.

What’s the thought logic for opening these new em residencies? Em isn’t really primary care and filling a shortage of primary care docs sure isn’t the argument

 

[southerndoc]

I was told that it's set up to approve almost every initial application and that they don't scrutinize places until the second visit.

They appear to have an emergency nurse practitioner fellowship program. Perhaps I'm wrong, but must you complete a residency prior to doing a fellowship?

 

[EctopicFetus]

Not sure. I know that where I'm at, they're definitely adding FM and IM. Radiology, neurosurgery, and a few others were being discussed.



National average for admission rate is <10% for all visits, per the CDC. I trained at a place with pretty good acuity. It was about 28% for 2 hospitals combined (~134,000 visits). One hospital I'm at now has ~95k visits and an admit rate around 20-25%. According to SAEM, some of the busiest county places aren't hitting 30% admission rates.

If your place has a 50% admit rate, then you're an out-lier.

The admit rate isn’t under 10%. Pull the citation as I’m calling bs. County spots might not be hitting 30% cause much of it is urgent care for the indigent. They at least have the other volume for training. A low volume low acuity shop is a disservice to the future patients these poor saps will be caring for. No decent job will hire them.

 

[deleted480308]

I was told that it's set up to approve almost every initial application and that they don't scrutinize places until the second visit.

They appear to have an emergency nurse practitioner fellowship program. Perhaps I'm wrong, but must you complete a residency prior to doing a fellowship?

that's what the midlevels are calling their "specialty training" now

 

[EctopicFetus]

Ed benchmarking alliance date below. take always. Free standing EDs and preds EDs are glorified urgent cares. Lower volume = lower admission. I found the cdc data. It’s obviously wrong. I assume the issue is they don’t count obs admits hence the discrepancy.

 

[Splenda88]

What’s the thought logic for opening these new em residencies? Em isn’t really primary care and filling a shortage of primary care docs sure isn’t the argument

Well, it has become a defacto primary care... How the heck a 200-bed hospital opening an EM residency?

 

[Rekt]

lol @ all the drama here. Look at it this way, from the perspective of a fresh-faced PGY-1 TY intern like me who's only doing a TY because they failed to match EM last year and is so crazy about doing EM that they would rather quit medicine if they couldn't. I'm from the Midwest, I have no ties to bum**** Mississippi (did I spell that right?), but if given the chance to do EM here versus the alternative, would I take it? Hells yeah.

This is exactly the problem? You were deemed unqualified in some regard and didn't match. Why should we hand out gold stars and trophies to everyone? Not everyone is cut out for EM. These weak inferior programs are only letting in applicants that most likely shouldn't be there in the first place.

 

[deleted480308]

This is exactly the problem? You were deemed unqualified in some regard and didn't match. Why should we hand out gold stars and trophies to everyone? Not everyone is cut out for EM. These weak inferior programs are only letting in applicants that most likely shouldn't be there in the first place.

I think it’s important to note that “can do the job” and “can outcompete other applicants in a competitive field of applicants” are different questions

The derm rejection pile is full of applicants who aren’t intellectually incapable of doing derm work

 

[Groove]

Call me old school but if it were up to me I'd shut down all EM residencies outside tertiary care academic institutions. I don't think EM has any business starting residencies in a community ED, no matter how many rotations you can farm out to your closest academic hospital.

Just when we were starting to gain credibility among sub specialists who I think have noticed in the past few years that EM residency trained docs are anything but idiots (with board scores to prove it) and are extremely well trained.... Now we're going to start pumping out Gomer Pyles from community programs. I could easily see myself hiring a well experienced FM doc who's been working EM versus a grad from one of these programs.

Anyway, whoever said it was money related is on the mark. I talked to one of the nearby academic EM ex chairs yesterday who said it's all about the money. He said he suspected much of it had to do with "low wage resident labor".

 

[betamale]

They'll probably rotate in Jackson and Memphis.

Dang, most of the FP EM fellowship program sites are better than that

 

[betamale]

Faculty Member of the Month | Emergency Medicine Residency

Can you guess who the Magnolia Regional Health Center Faculty Member o fthe Month is for September? Visit our website to find out who won!

www.mrhc.org

The prevalence and frequency of these new programs at subpar locations is getting ridiculous. I heard about this incoming new residency from a phone call with a CMG Sr. recruiter whom I've known for years and was discussing jobs and regional EM related news. I'm very familiar with this state and this region and I can't fathom why on earth someone would think to start an EM residency at this hospital of all places. This is not a slight against the newly hired dept chair...I know him personally and I like him. That being said, here are the stats:

Magnolia Regional is only a level III trauma center with 200 beds in the entire hospital. The ED sees only 33K pt's a year. The ED has only 25 beds! It's in Corinth, MS! The population is like...14K.

I mean, c'mon...why don't we just start a new EM residency at a FSED while we're at it. How do these things get approved? Yet another incoming residency at a ridiculous location that will only flood the market with even more grads. I wouldn't even be that upset if I had confidence that the residents would be well trained but this is a terrible location! They would have to be farmed out to NMMC in Tupelo, MS (75K, Level II, might as well be level I) huge hospital, to get any real training and exposure to quality pathology and medical subspecialties. I doubt that would even happen as I heard NMMC has a new FM EM fellowship. So, I have no idea where they would rotate other than MRHC. Crazy.

Dang, most of the FP EM fellowship program sites are better than that

 

[Brigade4Radiant]

The thing with EM is that if you don't see acuity and variety you will flounder.

 

[Tenk]

-Tell me about your training.

Well, over my three years I saw a combined total of over 9000 chronic back pains, URIs and med refills.

-Yeah but can you put in a chest tube? Run a code? Intubate someone?

No, but I can fill out disability forms and prescribe Percocet.

-You’re hired!!!

 

[GonnaBeADoc2222]

I think it’s important to note that “can do the job” and “can outcompete other applicants in a competitive field of applicants” are different questions

The derm rejection pile is full of applicants who aren’t intellectually incapable of doing derm work

Sure but we want the best right?

 

[TooMuchResearch]

So much acuity and procedures during residency. It was hard.
Makes community medicine life easier, and I feel confident I still know how to do those procedures that are no longer as frequent.

-Tell me about your training.

Well, over my three years I saw a combined total of over 9000 chronic back pains, URIs and med refills.

-Yeah but can you put in a chest tube? Run a code? Intubate someone?

No, but I can fill out disability forms and prescribe Percocet.

-You’re hired!!!

 

[Rekt]

I think it’s important to note that “can do the job” and “can outcompete other applicants in a competitive field of applicants” are different questions

The derm rejection pile is full of applicants who aren’t intellectually incapable of doing derm work

I agree for other specialities, but I feel EM is different. Almost all other specialities that are competitive are gated by scores, but EM is gated by performance. Now having met rotating students from the other side, it's very obvious who's actually cut out for it. Most are. But there's some definitely on the far left of the curve that aren't going to make it. But now they will with all these garbage HCA/rural spots popping up. Don't get me wrong, I'm not saying they're bad people at all. But not everyone should just get whatever they want.

 

[GonnaBeADoc2222]

Let me give a newsflash to all these med students that are supposedly pining over EM and willing to support some corporate meat factory in order to achieve matching in it. It's not that amazing. Nor is the rest of medicine. Nor is any other job. Any job is what you make of it. You can literally carve out a niche in any field medicine or otherwise that you choose to do.

Don't get me wrong. It's worked out for me overall and I'm glad I do it. But if I were a gastroenterologist or a radiologist or an engineer or a teacher or a diplomat I'm sure i would have similar gripes and jubilations during my experience.

Going to some 30k volume bfe shop where they farm you out all over the place for residency isn't going to make you a good physician. Either be good enough to get into a real program or do something else. You're not doing yourself, your patients, or the field any favors.

 

[EctopicFetus]

100% guarantee you never get a good job. The term bottom of the barrel comes to mind.

 

[scoopdaboop]

Money.

i meant by the acgme. how are they justifying opening new residencies that aren't primary care related?

 

[Splenda88]

If ACGME approves that place, maybe it's good enough to train people.

I am always skeptical of any residency that is in a hospital with <400 beds (whether IM, FM or whatever).

 

[GonnaBeADoc2222]

If ACGME approves that place, maybe it's good enough to train people.

No.

 

[GonnaBeADoc2222]

100% guarantee you never get a good job. The term bottom of the barrel comes to mind.

Problem is, people who are content to train at a dumpster like this are equally content to work for a CMG for the entirety of their career.

 

[VA Hopeful Dr]

If ACGME approves that place, maybe it's good enough to train people.

I am always skeptical of any residency that is in a hospital with <400 beds (whether IM, FM or whatever).

Then you're woefully misinformed as most FM programs straddle that line very closely. My state had 5 unopposed programs when I was in residency (2 opposed at large medical centers). 8 years ago all 5 were just under 400 beds (somewhere in the 380+ range).

In fact the program that is generally recognized as the top one in the country only has around 290 beds.

 

[TooMuchResearch]

Money? Yeah, probably money.

i meant by the acgme. how are they justifying opening new residencies that aren't primary care related?

 

[GonnaBeADoc2222]

It's always money. Money is the answer to every question.

Money? Yeah, probably money.

 

[scoopdaboop]

Money? Yeah, probably money.

how does the acgme make money on new residencies? they just acredit them right? I understand why the hospitals want them, but how does acgme profit on these residencies?

 

[gutonc]

how does the acgme make money on new residencies? they just acredit them right? I understand why the hospitals want them, but how does acgme profit on these residencies?

Do you think they provide their accreditation services pro bono?

 

[Splenda88]

Then you're woefully misinformed as most FM programs straddle that line very closely. My state had 5 unopposed programs when I was in residency (2 opposed at large medical centers). 8 years ago all 5 were just under 400 beds (somewhere in the 380+ range).

In fact the program that is generally recognized as the top one in the country only has around 290 beds.

I guess I spend too much time at these big academic centers...