Thoughts on interview day at Kaiser San Diego
This is the very first year of the program, and I think it’s the first ever Kaiser EM program. A family medicine program was started 2 years ago, so the hospital has had guinea pigs already. This is the largest ED in San Diego. The volume is good, but it is a Level 3 trauma center. It is a stroke center, but NOT a STEMI center. About 90% of the patients are Kaiser patients. EMS and walk ins will sometimes bring in pts who aren’t Kaiser. Faculty said that pathology is still broad despite most people having insurance for example a few AIDS patients presented. I will be one on one with attendings, and the attendings seemed very enthusiastic and the ED has been getting ready for the residents for 3 years now. It’s a pod style system. There’s also an observation area. I will learn bread and butter ED medicine here. We rotate elsewhere in SD for trauma and peds. Moonlighting is available as a 3rd year with Kaiser affiliates I will be able to get a job in San Diego. They were honest in the fact that it will be difficult for me to get an academic job in other parts of the country. However, the faculty comes from a wide range of residencies so networking is possible. Kaiser is working on an ultrasound fellowship and an admin or Sim fellowship also. Kaiser is working on having a medical school and nursing school, so they are definitely working towards education. The PD was very friendly as were the rest of the faculty. There is a triage system but the triage doc is there to put out fires and oversee the entire ED. They’re not like triage at USF or AAMC. It will be nice to be unopposed with regards to learners from other specialties. I am worried about the range of pathology that I will see and the lack of procedures. I am also concerned about how I will be treated at other hospitals being the first EM residents from Kaiser. Lastly, getting a job outside of SD or the Kaiser system may be difficult. I will NOT have name recognition with my residency and in some parts of the country it may be a negative. I would have to at least do 1 year at an outside hospital in SD to get some cred in order to work elsewhere in the US.
Big Positives:
1. I live in beautiful San Diego
2. I will have more one on one teaching with faculty
Big Negatives
1. It’s the first year of the program
2. My job search will be very limited after residency to San Diego or Kaiser hospitals
3. My residency will lack prestige and who knows it might close
4. 90% of my patients will have insurance, which is an unrealistic setting
