New San Diego EM Residency!!

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trkd

trkd

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Hey guys. I haven't posted in a while but just wanted to post info about a new program in the match for this upcoming winter. It's at my hospital, Kaiser Permanente- San Diego Medical Center. It's the busiest ER in San Diego with 100K patients/year. Awesome group of docs (although I may be biased). We have a group of 50 full-time docs including 3 ultrasound-fellowship trained (including me), a tox fellowship-trained, and an admin fellowship-trained faculty member. The PD, Matt Silver, is one of my favorites. Awesome guy and will do anything to make this the best residency. Unlike most Cali programs, it's a PGY1-3. We get peds but to get the best peds experience, residents go to Rady Children's Hospital here in town. Trauma at Mercy Hospital here in town. 6 residents/year to start. I don't need to say more about the city… paradise. Nowhere better in the US.

As you can tell, I'm pretty excited about it (the residency is why I joined the group 2 years ago). We are all committed to making this the best residency in the region. I'd be happy to answer any questions.

The website is: http://www.sdmeded.com

There will be more info on the site as time passes. Good luck in the match this year!
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I think a question you might see sooner rather than later will be... are you/will you accept student rotations/auditions this year and if so, how to apply for one? 🙂
 
Members don't see this ad :)
As for the clerkship, we have been taking med students for years (at least as many years as I've been here) so all are welcome to apply. On the website, there is a clerkship tab with some info and the contact info. I'll put it here too. The clerkship director is Dr. Don Mebust ([email protected]). I'm not sure what months are full/available but I think due to our volume and number of docs (up to 10 ER docs at prime hours down to 5 on the overnights), we are usually able to handle many students per month. Send him an email for more info.
 
trkd said:
Hey guys. I haven't posted in a while but just wanted to post info about a new program in the match for this upcoming winter. It's at my hospital, Kaiser Permanente- San Diego Medical Center. It's the busiest ER in San Diego with 100K patients/year. Awesome group of docs (although I may be biased). We have a group of 50 full-time docs including 3 ultrasound-fellowship trained (including me), a tox fellowship-trained, and an admin fellowship-trained faculty member. The PD, Matt Silver, is one of my favorites. Awesome guy and will do anything to make this the best residency. Unlike most Cali programs, it's a PGY1-3. We get peds but to get the best peds experience, residents go to Rady Children's Hospital here in town. Trauma at Mercy Hospital here in town. 6 residents/year to start. I don't need to say more about the city… paradise. Nowhere better in the US.

As you can tell, I'm pretty excited about it (the residency is why I joined the group 2 years ago). We are all committed to making this the best residency in the region. I'd be happy to answer any questions.

The website is: http://www.sdmeded.com

There will be more info on the site as time passes. Good luck in the match this year!
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When did Lapoint lose the muttonchops.
 
No chops for lapoint anymore.
 
True indeed DeadCactus. CDI, I'll ask the PD today. Not sure of the answer.
 
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tkim said:
sellout
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I still rock some aggressive 'burns from time to time. Tkim's facial hair jealously aside, I wanted to chime in and echo what's been said about the upcoming program. It is very exciting time here and the PD is a great guy and outstanding teacher. Stay tuned!
 
lapiz007 said:
I still rock some aggressive 'burns from time to time. Tkim's facial hair jealously aside, I wanted to chime in and echo what's been said about the upcoming program. It is very exciting time here and the PD is a great guy and outstanding teacher. Stay tuned!
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I am not jealous one bit. I can grow a Fu Manchu ANY DAMN DAY I WANT. Curiously, though, my pinkie nails get long simulataneously. Whatev.
 
lapiz007 said:
I still rock some aggressive 'burns from time to time. Tkim's facial hair jealously aside, I wanted to chime in and echo what's been said about the upcoming program. It is very exciting time here and the PD is a great guy and outstanding teacher. Stay tuned!
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It's about time chops comes out of the woodwork and chimes in.
 
I've contacted the person on the web page about a rotation over a week ago. Are you guys full?
 
roast said:
I've contacted the person on the web page about a rotation over a week ago. Are you guys full?
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Holler at me via private message with your name and contact info. I'll find out and get back to you. Depends on the month whether its full but not sure.

Go gators!.
 
the website says that the facility is a level 3 trauma center. can anyone elaborate for me on what this means as far as the amount of trauma and critical patients will be coming to this facility? i understand that residents will rotate through trauma rotations at an affiliated hospital, but the majority of the program will be spent at kaiser san diego, correct?
 
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le loup said:
the website says that the facility is a level 3 trauma center. can anyone elaborate for me on what this means as far as the amount of trauma and critical patients will be coming to this facility? i understand that residents will rotate through trauma rotations at an affiliated hospital, but the majority of the program will be spent at kaiser san diego, correct?
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Trauma center designation is only an indication of trauma, not critical patients. True trauma is rare as ems will take serious traumas to one of the 2 trauma centers in town. The other 18 ERs in town, including KP, only get traumas that need stabilization of traumas that occurred VERY close or some other unusual circumstance. Trauma will be done at Mercy (one of the 2 trauma centers) and peds will be done at the pedi hospital, Rady Children's, which is the only pedi trauma center in the region. Aside from that, the vast majority of time is in Kaiser. There is some community month in 3rd year to get a different feel for other ERs but not much else. I think there is one of the ICU months over at the Naval Medical Center because apparently that is great… maybe nicu or sicu or something. I can look up the specifics if anyone is interested. I have all of it in my stack of documents from our monthly residency meetings. But yes, large majority of time at KP. As for critical patients, we get our own critical patients, have an ICU, no need to transfer much of anything so the trauma designation is irrelevant.

For further clarification, hospitals get their trauma designation based on availability of trauma services, trauma training programs, etc NOT volume or anything like that. We have the highest ED volume in san diego. That's irrelevant. We have surgeons around 24/7 that can take a trauma pt to the OR if we cracked a chest but generally speaking, level 1 trauma centers are better prepared to do this. We just do it if we have to.
 
le loup said:
the website says that the facility is a level 3 trauma center. can anyone elaborate for me on what this means as far as the amount of trauma and critical patients will be coming to this facility? i understand that residents will rotate through trauma rotations at an affiliated hospital, but the majority of the program will be spent at kaiser san diego, correct?
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keep in mind that all EM programs have to meet a minimum requirement on procedures to be approved and in the end trauma is trauma, you will get sick of it. where i did med school, all the residents actually preferred working at the non trauma site because that means when things came in, it was just the ED residents, no surgeons.

anyway, the point is - you'll get good training anywhere you go. The RRC makes sure of that
 
CDI said:
Cool! Thanks!

Any idea about score requirements/cutoffs? Didn't see it on the site.
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If I remember correctly from my applying days, most places don't post cutoffs. I'm not sure if most places even have cut-offs. Maybe I'm wrong. Anyway, no definite cut-offs. As with all programs, I suppose it is the full package. I remember interviewing people at my previous program (before coming to San Diego) and we didn't have a cut-off but looked at the whole application. Some people weren't as strong on the boards but had amazing experiences. We took some of those residents and they ended up fantastic. Some of the residents that had very high boards weren't so great. The boards are helpful to determine whether someone will be able to later be successful on the boards. I'm not even sure if this correlation has been found to be true though. It may just be a way to torture residents and stratify them. Not sure. Nonetheless, everyone will be considered. Not specific to my program but just saying… the better the whole application is, the better the candidate looks (boards, CV, SLORs, all of it). My personal advise has always been to candidates, all you have to do is get to the interview. Once there, it is ALMOST an equal playing field. Have the right attitude and be a good personality fit with your program and you will likely get the job… wherever you choose to be.
 
trkd said:
If I remember correctly from my applying days, most places don't post cutoffs. I'm not sure if most places even have cut-offs. Maybe I'm wrong. Anyway, no definite cut-offs. As with all programs, I suppose it is the full package. I remember interviewing people at my previous program (before coming to San Diego) and we didn't have a cut-off but looked at the whole application. Some people weren't as strong on the boards but had amazing experiences. We took some of those residents and they ended up fantastic. Some of the residents that had very high boards weren't so great. The boards are helpful to determine whether someone will be able to later be successful on the boards. I'm not even sure if this correlation has been found to be true though. It may just be a way to torture residents and stratify them. Not sure. Nonetheless, everyone will be considered. Not specific to my program but just saying… the better the whole application is, the better the candidate looks (boards, CV, SLORs, all of it). My personal advise has always been to candidates, all you have to do is get to the interview. Once there, it is ALMOST an equal playing field. Have the right attitude and be a good personality fit with your program and you will likely get the job… wherever you choose to be.
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Thanks!

I guess its mostly IMG-heavy programs that tend to post board score cutoffs publicly. I certainly understand and appreciate your view on this!
 
trkd said:
If I remember correctly from my applying days, most places don't post cutoffs. I'm not sure if most places even have cut-offs. Maybe I'm wrong. Anyway, no definite cut-offs. As with all programs, I suppose it is the full package. I remember interviewing people at my previous program (before coming to San Diego) and we didn't have a cut-off but looked at the whole application. Some people weren't as strong on the boards but had amazing experiences. We took some of those residents and they ended up fantastic. Some of the residents that had very high boards weren't so great. The boards are helpful to determine whether someone will be able to later be successful on the boards. I'm not even sure if this correlation has been found to be true though. It may just be a way to torture residents and stratify them. Not sure. Nonetheless, everyone will be considered. Not specific to my program but just saying… the better the whole application is, the better the candidate looks (boards, CV, SLORs, all of it). My personal advise has always been to candidates, all you have to do is get to the interview. Once there, it is ALMOST an equal playing field. Have the right attitude and be a good personality fit with your program and you will likely get the job… wherever you choose to be.
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I hope that attitude is pervasive in most PDs minds cuz thinking that high boards= good fit is about as smart as saying "They have chest pain so it must be an MI". So many more factors to consider but unfortunately it often is the one that many seem to think is the most important. We shall see...
 
QuackaDO said:
I hope that attitude is pervasive in most PDs minds cuz thinking that high boards= good fit is about as smart as saying "They have chest pain so it must be an MI". So many more factors to consider but unfortunately it often is the one that many seem to think is the most important. We shall see...
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I imagine that most PDs have been burned enough times by sucky residents with high board scores. They are probably savvy to this. Having said that, I know that a FEW places that are probably still into numbers but likely the minority. But I'm no PD. Just been around a few since residency so take that with a grain of salt.
 
trkd said:
I imagine that most PDs have been burned enough times by sucky residents with high board scores. They are probably savvy to this. Having said that, I know that a FEW places that are probably still into numbers but likely the minority. But I'm no PD. Just been around a few since residency so take that with a grain of salt.
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Yeah, I suspect there are all flavors out there in terms of preferences. It's just picking through them and figuring out which is which that can become challenging sometimes but it's worth the time!
 
QuackaDO said:
Yeah, I suspect there are all flavors out there in terms of preferences. It's just picking through them and figuring out which is which that can become challenging sometimes but it's worth the time!
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My advice would be to just apply everywhere you are interested without trying to figure out what the PD is like. See where you get interviews and then assess the PDs when you get there. Otherwise, lots of time wasted. You want them to judge you based on a human interaction. I recommend you do the same. If you don't get an interview, then that is one less PD you need to learn more about. Just apply broadly and see which fish bite.
 
trkd said:
My advice would be to just apply everywhere you are interested without trying to figure out what the PD is like. See where you get interviews and then assess the PDs when you get there. Otherwise, lots of time wasted. You want them to judge you based on a human interaction. I recommend you do the same. If you don't get an interview, then that is one less PD you need to learn more about. Just apply broadly and see which fish bite.
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Hmmm... that's such simple and sensible advice yet for whatever reason I don't think I've ever really thought about it in that way. I always figured "doing my homework" would net me additional knowledge about the people, the process, and the chances but I actually like your point of "why waste time on them if they're not going to waste time on you". Good stuff... 👍
 
QuackaDO said:
Hmmm... that's such simple and sensible advice yet for whatever reason I don't think I've ever really thought about it in that way. I always figured "doing my homework" would net me additional knowledge about the people, the process, and the chances but I actually like your point of "why waste time on them if they're not going to waste time on you". Good stuff... 👍
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Don't try to game the system. At the application stage, the interview stage or the ROL stage. You will lose.

Apply where you want. Interview where you want (and they want...but that goes without saying). Rank where you want. The end. Do otherwise and you deserve the misery you get.
 
gutonc said:
Don't try to game the system. At the application stage, the interview stage or the ROL stage. You will lose.

Apply where you want. Interview where you want (and they want...but that goes without saying). Rank where you want. The end. Do otherwise and you deserve the misery you get.
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Exactly.

Having said all that, I don't think it is a bad idea to scope out places to some extent. I ended up applying to a bunch of places that were off of my radar but I figured I could pick through them later once I get interviews. The place I ended up going for residency was the last place I interviewed and I didn't know anything about it. I ended loving it at my interview and loved it for residency and fellowship. Amazing experience but I had never heard of it before ticking a box next to it when applying to a bunch of places in the region. Totally random pick.

If you are a weaker candidate for whatever reason, you apply more broadly. It is worth going out of your way a little to make sure you include programs that may be more likely to take you. If you are an IMG, scope out which residencies tend to take IMGs and make sure those are on your list. If you have terrible board scores, bad LORs, are an IMG or whatever, choose places that may be more likely to go lower down on their rank list. Some places you may think this would happen but they actually get top choice of their candidates but hard to make that call initially. Examples of such programs:

1. less desirable location (there are some amazing program is terrible cities… i.e. ecu in ashville)
2. take imgs (NOT an indicator of bad program but may be more likely to take you if you are an IMG and they have taken IMGs in the past)
3. have lots of DO residents (again, not a indicator of a bad program, just more likely to take you if you happen to be a DO and they have done this in the past)
4. newer programs (less of a reputation built up though not sure if this makes a huge difference since some of the newer programs that have opened in the past few years were in desirable locations which may negate the newness of the program to some extent… i.e. a few years ago u of washington opened and people were pretty jacked about it because of the location so I think they matched pretty well though I don't have the slightest idea how far down their list they went. I suspect our program will also not have too hard of a time due to location in paradise. The vegas program probably also did well. Back in the day I interviewed at a newer program recruiting for their 2nd class in a location that was desirable to me but their their first class appeared to suck pretty bad so you never can tell and always keep such programs on your radar).
 
Not to pour water on anybody's enthusiasm but Kaiser San Diego IS NOT
a designated trauma center.
see the American College of Surgeons http://www.facs.org/trauma/verified.html
as well as the California state EMS Authority http://www.emsa.ca.gov/systems/trauma/
("Trauma Centers in California")

With that being said, there is no reason that one needs to train at a trauma center.

Additionally, while the busiest ED in San Diego County, the acuity is not all that high. When I worked there part-time a few years ago, I was honestly kind of bored. My "fulltime" job was at the Naval Hospital San Diego. Care was pretty much regulated and scripted by clinical protocols at Kaiser. Lots of worried well and elderly patients with chronic non-life threatening complaints. I didn't admit anybody to a critical care setting and only saw one patient intubated in over two years of working there. The surgeons at that time were extremely reluctant to see trauma patients (even minor motor vehicle accidents) and some of them were upset when patients weren't immediately transferred to the Level I center. Additionally, KP San Diego does not have a cardiac cath lab. The standard operating procedure while I was there was to call "911" for a STEMI and wait for an ambulance to take the patient somewhere else. With that being said Kaiser is a place of great systems and resources. Great backup but not sure that it would have been a place that I would have felt good about training at simply because I didn't really see all that much. Things may have changed, its been 4-5 years but seriously something to consider for all of you that are looking at residency options. Everybody is looking for something a little bit different.

Agree that most of the EM attendings were great guys and gals (recognize some of the names of the core and teaching faculty on the website from the time that I was there) but few of them have published in the medical literature or are names that are heavily involved in the EM organizations and associations. At the time that I was working there, full time faculty worked 160hours a month. If that is still the case, that much time working clinical shifts may significantly limit their ability to prepare meaningful lectures (keeping up on the latest medical literature) or do research. Again, things may have changed but something to seriously consider in residency decision making.

Also might want to wait until official approval from the ACGME and RRC before getting too excited. The last program approved in California took three years to get residents from the time that it announced itself as a "new" program. It IS a State designated Level 3 facility and has a university affiliation.

Just two cents from someone who was there. Take it or leave it.
 
daruki said:
Not to pour water on anybody's enthusiasm but Kaiser San Diego IS NOT
a designated trauma center.
see the American College of Surgeons http://www.facs.org/trauma/verified.html
as well as the California state EMS Authority http://www.emsa.ca.gov/systems/trauma/
("Trauma Centers in California")

With that being said, there is no reason that one needs to train at a trauma center.

Additionally, while the busiest ED in San Diego County, the acuity is not all that high. When I worked there part-time a few years ago, I was honestly kind of bored. My "fulltime" job was at the Naval Hospital San Diego. Care was pretty much regulated and scripted by clinical protocols at Kaiser. Lots of worried well and elderly patients with chronic non-life threatening complaints. I didn't admit anybody to a critical care setting and only saw one patient intubated in over two years of working there. The surgeons at that time were extremely reluctant to see trauma patients (even minor motor vehicle accidents) and some of them were upset when patients weren't immediately transferred to the Level I center. Additionally, KP San Diego does not have a cardiac cath lab. The standard operating procedure while I was there was to call "911" for a STEMI and wait for an ambulance to take the patient somewhere else. With that being said Kaiser is a place of great systems and resources. Great backup but not sure that it would have been a place that I would have felt good about training at simply because I didn't really see all that much. Things may have changed, its been 4-5 years but seriously something to consider for all of you that are looking at residency options. Everybody is looking for something a little bit different.

Agree that most of the EM attendings were great guys and gals (recognize some of the names of the core and teaching faculty on the website from the time that I was there) but few of them have published in the medical literature or are names that are heavily involved in the EM organizations and associations. At the time that I was working there, full time faculty worked 160hours a month. If that is still the case, that much time working clinical shifts may significantly limit their ability to prepare meaningful lectures (keeping up on the latest medical literature) or do research. Again, things may have changed but something to seriously consider in residency decision making.

Also might want to wait until official approval from the ACGME and RRC before getting too excited. The last program approved in California took three years to get residents from the time that it announced itself as a "new" program. It IS a State designated Level 3 facility and has a university affiliation.

Just two cents from someone who was there. Take it or leave it.
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Totally agree that you have to consider all things. I trained at a trauma center and loved it. Many people I know didn't and said that their trauma months were awesome because that's all they did. The truth of the matter is that there is not a whole lot of trauma in San Diego all together so if that is what you are looking for, this is the wrong town to train for knife and gun type stuff. There acuity is also lower than where I trained percentage wise but fortunately the PD has a set up that is more conducive to this in that the pod run by a resident and single attending will get all the highest acuity. A single resident getting the most acute at all times is bound to see some good stuff. Again, not going to be cracking chests all day though. As for faculty hours, RRC requires that core faculty not work more than 28 hours/week so it's not really negotiable. Right now everyone gets 4 hours a week protected for just professional development. Core will go up to at least 12 protected a week or more depending on what they are doing. That's not really a concern. As for being published and big names in EM, totally true. Many of the faculty are younger though getting more into research/publishing. I can't say I know how much of difference that makes as I didn't have that either though my faculty were very involved and interested in teaching. We had one faculty member who had written somewhat of a landmark paper years ago but no one else. I'm not really able to judge if that's important. I guess it would be better to ask some folks that trained under the big dogs. STEMI and stroke receiving center but yes, the stems are sent by paramedic or critical-care transport to a contracted cath lab in la jolla. Not sure it matters as long as you see the stemis but still a fact. Lastly, site visit has already happened and approval is expected when the RRC meets in Sept so I guess there will be a long period of time from the official approval to when people are interviewing/ranking so there doesn't really need to be so much fear.

I think there are some valid points that daruki makes though. You have to decide the kind of environment you are looking to train and eventually work. If you want lots of penetrating trauma, you just won't get that anywhere is san diego regardless of which program you choose. You have to hit up some more violent cities. There are tons of programs that can provide you with this. Just not gonna happen at any of the 3 san diego programs (well only 2 available to civilians). If you think big names/publications are important, go to denver or some other places very heavy on research and such. There are some amazing programs out there for this. If you are looking for a busy community ED, this is a consideration. The vast majority of EM grads around the country end up working in community EDs and you will be extremely well prepared for this. But everyone is looking for something different. You have to look around and see what is best for you. There is no one program that is perfect for everyone. That's the point of interviews and researching programs as well as chatting to others like us on the forum who have been through this and all have different experiences.
 
I may not be the most qualified (IMG), but I may just have to apply anyways cause you've sold the program so well. :laugh:
 
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
 
Currently a EM PGY-1 in another california program but just wanted to give a shout-out to the awesome EM group at Kaiser. Did a rotation there as a 4th year student before the EM program was in place and had a phenomenal experience. The PD Dr. Silver is incredibly awesome and down to earth and will go out of his way to help and teach, and that extends to all of the physicians that I worked with there. In regards to the younger faculty, this is just me but I liked how most of the attendings were younger and more enthusiastic. They were all super enthusiastic and being younger it was easier to connect with them on all things EM and non-EM related (ie. football, SD, sports, etc.) Definitely no old, stodgy attendings here.

Oh, and did I mention the location? 15 min from downtown, PB, seaworld, balboa park, san diego zoo, la jolla, UCSD, etc. You could finish a morning shift and still have time to tan/swim/run the beaches. Doesn't get better than that.

Students who match here will have a great learning (and living) experience, regardless if they want to stay in SD or go elsewhere. Definitely give this program a look (and try to schedule an away rotation ASAP) if you're interested.
 
daruki said:
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
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All very important points to consider from Daruki. There are a few points to make though. It is indeed true that KP is not a STEMI receiving hospital (well… yet, at least until the new hospital opens at which time it will have it's own cath lab). As for trauma, many programs around the country rotate at trauma programs for exactly this reason. Again, as stated before, I can't speak to having that experience myself but many of my colleagues and friends in EM went through such programs and did great. I really can't speak for which is better as I only did residency at a trauma center.

However, as for the job market, I must disagree. Doing residency in any city doesn't guarantee a job after but it sure does make it A LOT easier. This is evidenced by the huge numbers of UCSD residents working around town (including many at Kaiser). Just thought I would point that out. You work in town, you meet people, you network, you get a job. Many people I know including myself and my husband have had this experience. We are both fellowship trained. That certainly didn't hurt. But we came to this city specifically for my husband to do fellowship and open doors for a sweet job (which he got) and I just had to pry open the door myself. Certainly a very difficult market though. There is no doubt about that. There ARE many people working per diem jobs at 2 or 3 places to get a good gig. However, persistence pays off and I have seen MANY of those people get hired into full time spots with the right attitude and work ethic (which doesn't include 7 years of overnights or anything crazy like that). There are a few places in town that do try to pull that kind of crap (and most of us know where those are) but keep in mind there are 20 ERs in town. Some are owned by the same group so it's not 20 different groups hiring but you get the idea. If you have a city you want to work in, it is absolutely in your best interest to consider residency or fellowship in those places. I think few people will tell you otherwise. Furthermore, if there is a city you want to work in, working at a few ERs in town until you find the right one to get your foot in the door is also a great option. Yeah it might suck to not just get a great job right out of residency but that is the price you pay if you want to work in a highly desirable city.
 
Are you guying hiring attendings? 😉
 
Ceez said:
Are you guying hiring attendings? 😉
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We were hiring for a few spots. We filled 2. Not sure if there was a 3rd. Let me check. Are you in town? PM me your info. If there's a spot, I'll send you the contact info for our chief.
 
Our residency coordinator just started. We've been waiting awhile. It's been a little tight stretching our dept coordinators to do all the student inquiries and rotator scheduling. So anyone who had difficulty before, please contact:

[email protected]

She'll be dedicated to only doing the residency and student stuff so much easier to get ahold of. I'll get her number up as soon as I get it. I haven't even met her yet but I hear from the interviews that she is great and lots of experience.
 
Is there a ACGME ID? I don't see the program listed on FREIDA or ERAS. You will be accepting applicants for this coming 13-14 cycle?
 
secants said:
Is there a ACGME ID? I don't see the program listed on FREIDA or ERAS. You will be accepting applicants for this coming 13-14 cycle?
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It'll be there around 2nd week of sept so check the website again then. We get the ID # around sept 10. And absolutely accepting applicants this upcoming cycle. Unfortunately have to wait for RRC meeting sept 6 to get on the website. I'll post the info here when it goes down in a few weeks so it'll be on there in plenty of time.
 
The program just got accredited by the ACGME!!! It should be on FREIDA by the end of the week or early next week.
 
Nevermind. On FREIDA now! ID number 110-05-00-214. Good luck to everyone entering the match this year!!
 
The application for ERAS for our program was submitted on Tuesday of this week (9/10/13) and it takes 5-10 business days to process. Please just keep checking. It will show up.
 
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