A very even handed and appropriate response from trkd for things for all potential EM residents to think about with any program.
For all of the potential residents out there, just remember that there is more to trauma than penetrating (gun and knife club stuff). As a military emergency physician, I saw more than enough of my share of penetrating and blunt trauma in hot dirty dusty places overseas. I appreciated my residency training where I took care of and intubated so many trauma patients (both blunt and penetrating) that I lost track. Meeting the minimum numbers for procedures required by the RRC does not and should not equate to expertise in my opinion.
From an ED perspective, penetrating trauma is not all that interesting but blunt trauma makes up the bulk of trauma system activations in most places in the United States and is very interesting from an Emergency Physician perspective in my opinion.
It is fairly easy to get the breakdown of the ratio of blunt/penetrating trauma in most cities by looking for the EMS or trauma system report for that particular city. For example in 2010, there were 758 penetrating trauma patients in the County of San Diego, there were 9,654 (93%) blunt trauma patients. see
www.sdcounty.ca.gov/hhsa/programs/phs/.../EMS-Trauma_Report_2012.pdf. So while there aren't too many persons being "violent" with one another (stab or gunshot), there are plenty of people still getting in accidents or falling, etc.
In contrast, between 1992 and 2002 there were 161,838 trauma activations in Los Angeles County (roughly 16,184 per year) of which 47,161(4,7161/year) were penetrating. This leaves roughly 70% of trauma activations as being blunt trauma even in a city with a fairly high rate of penetrating trauma. see
http://archsurg.jamanetwork.com/article.aspx?articleid=397759
Without any reference to Kaiser SD or any other potential program, most community ED's are not going to be seeing gun and stab wounds but they'll be seeing plenty of MVAs, MCA's, auto vs peds, falls, elderly on coumadin or other blood thinners with head trauma, assaults, etc. STEMIs and CVAs. If you haven't seen too much of it as a resident, how are you going to take care of it when you are the attending?
Again, just for clarification, Kaiser San Diego IS NOT a STEMI Receiving Hospital so you may not be seeing that many STEMIs in the first place.
see
http://www.sdcounty.ca.gov/hhsa/programs/phs/emergency_medical_services/prehospital_system.html
That may or may not be important to you but make sure that you have all of the facts before you make a decision about where you are going to train and make sure that you ask questions and followup. Trust but verify
San Diego is a horribly saturated job market. (Routinely listed as one of the hardest places in the US to get a full time job in EM). Lots of people in SD working two or three part-time job in the ED hoping for a full time offer at some point in the future. There are some places that require nights and weekends for 7 years before even being considered for partnership. Doing a residency in SD is not going to make it any easier to get a job there upon completion.
Again, just my two cents, Take it or leave it