Does anyone have experience with the rotation or residency program here to shed some light on what to expect? I've had someone tell me that the program is on the stiff side, but also am reluctant to trust just one perspective. I know it's a busy ER with what I can expect to be a diversity of pathology, but am curious as to what the culture is like.
New York Presbyterian ER Experience
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i don't know about the culture, but it seems like the training just isn't up to par with the other NYC programs. I was really interested in this program, so hearing this was very disappointing to me. it seems like the interests of the faculty are academic>>>>>clinical, so they're aren't the greatest teachers. Which directly impact the residents, as you might imagine.
Academic name is great.... but you're going to residency to learn how to practice medicine, not to produce gobs of research.
I also heard working in the ER is frustrating b/c so many of the patients speak Spanish... and only Spanish, and translators aren't always available. Yeah, building up on your medical spanish is cool.... but when I'm an intern I want to be learning clinical medicine and skills to help me be more efficient, not cool new Spanish words lol.
But I think it depends on the person. It seems like it would be a nice place to do a fellowship, but I don't know how great of a place it is for residency training..... I did hear you see a bunch of interesting pathology at the Columbia site tho. I heard the Cornell site is pretty sleepy...
Academic name is great.... but you're going to residency to learn how to practice medicine, not to produce gobs of research.
I also heard working in the ER is frustrating b/c so many of the patients speak Spanish... and only Spanish, and translators aren't always available. Yeah, building up on your medical spanish is cool.... but when I'm an intern I want to be learning clinical medicine and skills to help me be more efficient, not cool new Spanish words lol.
But I think it depends on the person. It seems like it would be a nice place to do a fellowship, but I don't know how great of a place it is for residency training..... I did hear you see a bunch of interesting pathology at the Columbia site tho. I heard the Cornell site is pretty sleepy...
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See I've been on rotation at two of the NYC EM sites. They both said the same thing. Each major program in NYC has its own feel. And both programs basically pegged the other programs (and themselves) the same way, so it has inter-rater reliability.
NYP: Great if you wanna do some research out of your residency, but the actual EM experience is somewhat of a clusterf**k since they basically have stretchers covering every free inch of space and a few attendings who may or may not be pawning off all of the work and thinking to the 2nd and 3rd year residents. Literally heard it described as "a third world country warzone within one of the best hospitals in america".
St Lukes/Roosevelt: Considered the "fun" choice. Its the one in midtown (and columbia campus) and probably has the staff thats most dedicated to education. 50% of your time is spent in Roosevelt, which doesnt see many traumas. 50% is spent in SL, which sees plenty. "balanced"
Jacobi: Trauma trauma trauma trauma trauma.
Lincoln: el trauma, el trauma, el trauma, el trauma, el trauma (see what i did there?)
Bellevue: the place to go for psych ER. Also has above average amount of trauma.
Cornell: "You go to cornell to be in a good "A"partment, not a good "D"partment". And that's prob not a hit on cornell at all. I was just over there for an non-academic matter and their ER seems fine. Just the general knock on everything about Cornell. Its always going to be third or fourth place in everything (except cancer, because of MSKCC) within the city because it has little besides the Weil Cornell name to make it unique in the overcrowded city hospital scene.
I dont know about the rest of the places, honestly.
NYP: Great if you wanna do some research out of your residency, but the actual EM experience is somewhat of a clusterf**k since they basically have stretchers covering every free inch of space and a few attendings who may or may not be pawning off all of the work and thinking to the 2nd and 3rd year residents. Literally heard it described as "a third world country warzone within one of the best hospitals in america".
St Lukes/Roosevelt: Considered the "fun" choice. Its the one in midtown (and columbia campus) and probably has the staff thats most dedicated to education. 50% of your time is spent in Roosevelt, which doesnt see many traumas. 50% is spent in SL, which sees plenty. "balanced"
Jacobi: Trauma trauma trauma trauma trauma.
Lincoln: el trauma, el trauma, el trauma, el trauma, el trauma (see what i did there?)
Bellevue: the place to go for psych ER. Also has above average amount of trauma.
Cornell: "You go to cornell to be in a good "A"partment, not a good "D"partment". And that's prob not a hit on cornell at all. I was just over there for an non-academic matter and their ER seems fine. Just the general knock on everything about Cornell. Its always going to be third or fourth place in everything (except cancer, because of MSKCC) within the city because it has little besides the Weil Cornell name to make it unique in the overcrowded city hospital scene.
I dont know about the rest of the places, honestly.
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Please clarify NYP vs Cornell, in that the NYP program is Cornell and Columbia hospitals. The offices for the NYP residency are even at Cornell.
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I should be more clear when I say I'm referring to the advice for rotations. It has a lot.of overlap with residency, but there are quirks. See: you can apply to do em at nyp, which is both sites, or just Cornell. But never just Columbia nyp. That's an elective only quirk as best as I cab tell you can't do that for residency.
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I applied to do an EM rotation through Cornell and it was NYP together. I believe you are mistaken.
Everything said about Columbia is true though. While I was walking through the department I had patients that had waited hours and hours tugging on my coat telling me that their chest hurt and to please do something. I was told by an attending that they don't worry too much about how long people wait because "if people don't have to wait as long, more people will just fill in behind them." Granted, they do a good job of identifying people at triage and getting the sick ones back. Also their nursing staff is terrible, and if you don't speak Spanish well, this rotation will be miserable.
At Cornell I had an attending that told me only to see patients with a resident and not by myself since then she would have too much paperwork to do charting everything. Teaching was actually really good as a student, their didactics are awesome, and they tend to use non-EM residents for being paper-pushing monkeys more than the EM ones but in general it wasn't a great experience.
Everything said about Columbia is true though. While I was walking through the department I had patients that had waited hours and hours tugging on my coat telling me that their chest hurt and to please do something. I was told by an attending that they don't worry too much about how long people wait because "if people don't have to wait as long, more people will just fill in behind them." Granted, they do a good job of identifying people at triage and getting the sick ones back. Also their nursing staff is terrible, and if you don't speak Spanish well, this rotation will be miserable.
At Cornell I had an attending that told me only to see patients with a resident and not by myself since then she would have too much paperwork to do charting everything. Teaching was actually really good as a student, their didactics are awesome, and they tend to use non-EM residents for being paper-pushing monkeys more than the EM ones but in general it wasn't a great experience.
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I am a resident at NYP and I like my program. Thought I should clear up some things. Obviously I am going to be biased in my point of view, but I will try to be as objective as possible:
NYP is both Cornell and Columbia. You CAN NOT do a residency at either campus alone. It is 1 program. We spend about 50% of our time at either campus. They are very different experiences and complement each other nicely.
Columbia: very busy ER. One of the busiest in the city. Fairly sick population as no one has a PMD or gets any care for chronic illnesses. The 'warzone' description is accurate, though I am surprised it seemed to be stated in a negative way. Most people who like EM kind of relish that sort of experience. I definitely enjoy working at Columbia in a large part because it is so overwhelming.
Cornell: lower volume, sometimes fairly busy, sometimes slows down. Mostly an Upper East Side population, so you get some 'boutique medicine' aspect to the place, but between it being a burn center, and all the super sick MSK patients from across the street, its actually a fairly sick patient population.
We do a couple of things better than I've seen any other place do:
Ultrasound: we do 1 shift a month where we don't see patients but only go around the department doing ultrasounds. This builds up your ultrasound skills very quickly. Any images we file count towards RDMS certification. I expect to be RDMS certified by the time I graduate.
Peds: we do Peds ER at MSCHONY, which is phenomenal. So many places have a sub par peds experience, and it tends to be underemphasized, but this is super important especially for anyone who wants to work in the community.
Didactics: senior resident lectures and noon reports were better than at any place I've seen. May not sound that important, but considering you have so little time to read intern year, its kind of nice to get such high quality teaching.
To be fair, here are a couple of things some people may consider negatives:
1) We work a lot. 18 x 12 hour shifts in a 28 day block for the first 2 years. That's more than many places, especially more than most 4 year programs. Part of that comes from the philosophy of 'you learn by doing' that is prevalent here. It's true for me, so I think of it as a plus. However, I can see how some people would be put off by this.
2) For complicated historical reasons, we are not allowed to moonlight. I will not go into a discussion of how necessary that is at a 4 year program with a 'pre-attending' year.
In summary, pros and cons:
+ 2 campus experience
+ amazing off service rotations
+ procedure rich and interns get first crack at every procedure
+ PD is spectacular
+ good didactics
+ ultrasound experience
+ housing
+/- resident run (I always thought of this as a plus, but apparently some posters here are discontent that residents are "pawned off all the work and thinking" I honestly don't know what to say to that. If you don't like to think or work, don't go here)
+/- learn by doing approach (I love it personally, but I know some people like their hands held)
- Columbia sort of forces you to pick up at least some Spanish
- a lot of shifts
- can not moonlight
If you have any questions about the program feel free to ask me on this thread or PM me.
NYP is both Cornell and Columbia. You CAN NOT do a residency at either campus alone. It is 1 program. We spend about 50% of our time at either campus. They are very different experiences and complement each other nicely.
Columbia: very busy ER. One of the busiest in the city. Fairly sick population as no one has a PMD or gets any care for chronic illnesses. The 'warzone' description is accurate, though I am surprised it seemed to be stated in a negative way. Most people who like EM kind of relish that sort of experience. I definitely enjoy working at Columbia in a large part because it is so overwhelming.
Cornell: lower volume, sometimes fairly busy, sometimes slows down. Mostly an Upper East Side population, so you get some 'boutique medicine' aspect to the place, but between it being a burn center, and all the super sick MSK patients from across the street, its actually a fairly sick patient population.
We do a couple of things better than I've seen any other place do:
Ultrasound: we do 1 shift a month where we don't see patients but only go around the department doing ultrasounds. This builds up your ultrasound skills very quickly. Any images we file count towards RDMS certification. I expect to be RDMS certified by the time I graduate.
Peds: we do Peds ER at MSCHONY, which is phenomenal. So many places have a sub par peds experience, and it tends to be underemphasized, but this is super important especially for anyone who wants to work in the community.
Didactics: senior resident lectures and noon reports were better than at any place I've seen. May not sound that important, but considering you have so little time to read intern year, its kind of nice to get such high quality teaching.
To be fair, here are a couple of things some people may consider negatives:
1) We work a lot. 18 x 12 hour shifts in a 28 day block for the first 2 years. That's more than many places, especially more than most 4 year programs. Part of that comes from the philosophy of 'you learn by doing' that is prevalent here. It's true for me, so I think of it as a plus. However, I can see how some people would be put off by this.
2) For complicated historical reasons, we are not allowed to moonlight. I will not go into a discussion of how necessary that is at a 4 year program with a 'pre-attending' year.
In summary, pros and cons:
+ 2 campus experience
+ amazing off service rotations
+ procedure rich and interns get first crack at every procedure
+ PD is spectacular
+ good didactics
+ ultrasound experience
+ housing
+/- resident run (I always thought of this as a plus, but apparently some posters here are discontent that residents are "pawned off all the work and thinking" I honestly don't know what to say to that. If you don't like to think or work, don't go here)
+/- learn by doing approach (I love it personally, but I know some people like their hands held)
- Columbia sort of forces you to pick up at least some Spanish
- a lot of shifts
- can not moonlight
If you have any questions about the program feel free to ask me on this thread or PM me.
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As an afterthought, another potential negative is that we see fairly little trauma. We definitely see enough to become comfortable with it very quickly, but not as much as, say, King's County. I think the very sick patient population more than makes up for it, but if trauma is your academic interest, might be an idea to look outside of NYC.
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What residency programs in New York are good for someone who wants Trauma?......and is fluent in Spanish.
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i don't know that you can say one place has the staff that's most dedicated to education if you've only rotated at 2 places, lol
none. If you want tons of trauma, NYC is not the place to be. But you really don't need a lot of trauma for EM. You'll find just enough everywhere to be competent, especially from the ED perspective since it's so algorithm driven on our end. As for spanish, all NYC and surrounding area EDs have enough of a spanish population where speaking it is a benefit. Hell, when I left med school in the city and ended up at Stony Brook way out in Long Island, I still used Spanish every single shift.
He is right however, SLR likes to be very academic. Mt. Sinai is also extremely academic overall, and an argument could be made that it is better than SLR the last couple years. They've been working very strongly on that aspect of their program.
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So where is all the trauma? Please don't say army, not interested in going that route. I would think nyc would just due to location. How do u guys find out what hospitals see lots of trauma? Are u basing it on trauma level, hospital stats, what?
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If you want tons of penetrating trauma, pick your favorite "dangerous" city and go there. Detroit and Baltimore programs will offer lots. Blunt trauma can be found anywhere there are roads, but the more Level 1's in town the more they will get divided up.
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NYC is just too safe a city. Almost no gun violence and heavy public transport use. Also lots of hospitals. All adds up to not too much trauma.
Agree with Detroit and Baltimore (although from what I hear Shock Trauma sucks up most of Baltimore in that sense). Places like Memphis. Vegas?
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Dont forget Chicago and Los Angeles - no lack of penetrating trauma
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Downstate/King's County is still pretty much a knife and gun club if you think you need that sort of thing. Also a fair amount of MVC/ped/cyclist/blunt trauma. Less competition than in Manhattan.
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Detroit? No thanks! That's my home town. I'm part of the mass exodus, but I'm sick of Phoenix. I need to have a better view and more tolerable summers (and no cold winters).
So is an "academic" program one which focuses on research or is it a program where they actually focus on educating the residents instead of having them produce research? For example UCSD says on their site they expect applicants to have gobs of research....are they considered academic?
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From what I hear and the data (at least for penetrating trauma), the residents at Kings County would probably disagree (very similar to the amount of trauma at LAC-USC, which few question)...I also hear Jacobi and Lincoln see a fair bit (not recommending, just saying)
HH
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Yeah, but if you're data is from King's County Residents/attendings they are "number one at everything".
Can't speak to Kings County for sure, but I highly doubt it. This isn't the 80's anymore, the gun knife club left the city, and I can speak for Jacobi/Lincoln as I did med school in the Bronx.
That said, I'm still unsure why the med student wants tons of trauma, I'd think that trauma surg would be better since EM trauma is really rote after the first several traumas.
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I want lots of trauma because I will end up moving to Israel at some point after I am done with my residency (fiance is Israeli), so I would want to have as much trauma experience under my belt as possible because it may come in handy depending on what the war/peace situation is at the time. Either way in Israel it will always be handy, given the possibility of the suicide bombings and missile attacks becoming frequently closer to the big cities. And I don't want to sign up to a few years of indentured servitude with the army so looking for it in residency. I either want an awesome location like San Diego or a program that sees a good amount of trauma (which prob wont be in such a desirable location).
And trauma surgery is not an option because I'll be pushing 30 by the time I graduate Med school so I really can't wait 6+ years to start having kids....kind of a girl problem, I'm sure you can't relate....
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Honest question - have you looked into getting licensed in Israel yet? I don't know if you know, but you have to pass a Hebrew language test, and are you going to officially make Aliyah, or just be there part of the year?
I do not mean to offend you, if you already are aware of the issues.
Is going to Israel after med school and doing residency there an option? Either way, you want penetrating and blast trauma. You won't find the latter outside of the army, honestly. The former you will not find a sufficient amount of for your needs in NYC no matter where you go. Maryland shock trauma or other major cities are better for you. That said, trauma is truly rote. By your 10th penetrating trauma, you'll be fine, lol.
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Nope not an option. If you study in the states you need to finish you residency and get fully licensed in the USA before Israel will accept your MD license. Plus I'd like to have my license also available in the USA because a lot of American physicians come back to the states for 3 months out of the year to practice and make more $$$ because you don't make much in Israel.
Well good to know not a lot of experiences are needed to get the hang out it! I keep hearing Maryland for trauma....somehow I didn't know it was on the list of most dangerous cities. Penetrating trauma is fine to at least have a good hang of it...most ppl who suffer in the suicide bombs and are savable, suffer from the scrap metal and other crap penetrating not directly from the blast. So penetrating trauma is good enough.
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Remember it's not trauma per hospital that matters, it's trauma per resident. So If a place sees lots of trauma but you only see it during your one month a year trauma rotation, you probably have less experience than someone who is at a place where it is less crazy, but you get to see whatever comes in during your shift. Sure you need a certain number of chest tubes. But also be aware that places that have lots of trauma tend to have strong trauma surgery services, so you may be fighting more with surgery to get the chest tube or you may feel like you never really get to run the resuscitation.
