Non-academic Level I designations?

[bulgethetwine]

Do Level I trauma centers outside academic centers really exist?

I've looked. I only know of one, in Raleigh, N.C., and even that one has rotating residents.

Any others around, ANYWHERE in the U.S.?

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[peksi]

Clarify academic...do you mean university hospitals. Residency program etc?

Eg. is your question. Are there any non-university, Level one trauma centers in the USA? The answer is yes, also nknow that there are two kinds of trauma designations ACS and state designated systems. There is often overlap here but is not 100%.

Paul

 

[Toohotinvegas33]

Let me hijack this thread for a minute. Is there a significant difference in eduaction for EM between a program that is in a level I and a program that is in a level II that does trauma rotations at a level I?

 

[bulgethetwine]

Let me hijack this thread for a minute. Is there a significant difference in eduaction for EM between a program that is in a level I and a program that is in a level II that does trauma rotations at a level I?

Just let me stop the hijacks for a minute at least 🙂 The thread is only an hour old for God sake!

Let me rephrase: Are there Level I trauma centers staffed by democratic groups, i.e. not under the thumb of the university and/or residency program at large? I'm wondering if it is possible to get the best of what I consider both worlds: High acuity and high volume but with the benefits of working for a democratic group (i.e. autonomy and salary).

I guess an alternate way to phrase this is: Are there any Level I community hospitals?

 

[lucky_deadman]

Do Level I trauma centers outside academic centers really exist?

I've looked. I only know of one, in Raleigh, N.C., and even that one has rotating residents.

Any others around, ANYWHERE in the U.S.?

There are multiple Level I trauma centers in Virginia and Tennessee. Some in TN have surgery residents rotating through but it's only one of their training sites. No EM residents (at least not yet). Not positive about the Virginia ones.

 

[FISKUS]

There are multiple "level one" trauma centers in Illinois - not a single one is ACS certified. I know of 2 level one centers in Rockford IL that do not sponsor residencies ( they do have occasional rotating residents)

 

[Miami_med]

There is a level 1 Trauma center a mile from my house that only rotates an occasioanl surgery resident from a hospital 10 miles away.

 

[crewmaster1]

Just let me stop the hijacks for a minute at least 🙂 The thread is only an hour old for God sake!

Let me rephrase: Are there Level I trauma centers staffed by democratic groups, i.e. not under the thumb of the university and/or residency program at large? I'm wondering if it is possible to get the best of what I consider both worlds: High acuity and high volume but with the benefits of working for a democratic group (i.e. autonomy and salary).

I guess an alternate way to phrase this is: Are there any Level I community hospitals?

University of Cincinnati. Vanguard is the physician group and 1/2 pay from group 1/2 pay from university. Don't know if I would totally call it democratic, but it is the closest I've seen to private groups staffing a university hospital level 1.

 

[GeneralVeers]

Let me hijack this thread for a minute. Is there a significant difference in eduaction for EM between a program that is in a level I and a program that is in a level II that does trauma rotations at a level I?

The answer is no.....for EM. The difference between a level I and a level II center is the presence of a research program. As far as EM goes, the patient acuity and training for a Level I and II are the same. I've been at both types of programs and can tell you that there is no difference.

 

[matt_mt19]

There is an ACS level 1 mecca university hospital, then 8 miles west there is a state level 1 community hospital...:

ACS lev 1 mecca (residents) = (penetrating + blunt) + volume
&
Community (democratic - residents) = blunt - penetrating - volume

You do the math.

Obviously not the set-up everywhere, but that's the basics in STL.

 

[ERMudPhud]

Denver has two community level ones. Both sponsor family practice residencies but otherwise have no academic ties. Both are staffed by independent, fee for service, democratic groups.

 

[deleted109597]

Our surgery residency program is only vaguely affiliated with an academic center more than 200 miles away, we only have surgery and FM, and we still have a level 1 center. In fact, we see more patients than every other hospital in the state, and only 1 in North Carolina beats us.
The only thing Level 1 means is that there are on call people for every modality, and that the helicopters and bandaid boxes will bring you everything. Level 2s can see the exact same thing, they simply stabilize and ship (or fail to stabilize and ship in a different container).

 

[bulgethetwine]

Denver has two community level ones. Both sponsor family practice residencies but otherwise have no academic ties. Both are staffed by independent, fee for service, democratic groups.

Do the FM residents actually work in the ED?

 

[ccfccp]

University Hospital in San Antonio is one of the few "academic programs" that I know of with a level 1 trauma center (servicing all of south Texas) that does not have an EM residency. They do have IM and FM residents rotate through though. They use a lot of PAs instead of residents for much of the work.

 

[Miami_med]

Atleast as of right now, there is no EM residency here at Jackson Memorial in Miami, which is the largest single site hospital and one of the largest Level I centers in the country. Of course, we have every other residency known to man, and this will also probably change.

 

[Dr. Will]

Atleast as of right now, there is no EM residency here at Jackson Memorial in Miami, which is the largest single site hospital and one of the largest Level I centers in the country. Of course, we have every other residency known to man, and this will also probably change.

I've always wondered why this was the case, and why there really isn't one allopathic EM residency in Miami period. (I know there is a DO residency there, but I'm not sure where they are based). Any idea why this is the case for Jackson Memorial? I figure based on size and location, that this would be a great place to train for EM.

 

[Dr.Evil1]

Just let me stop the hijacks for a minute at least 🙂 The thread is only an hour old for God sake!

Let me rephrase: Are there Level I trauma centers staffed by democratic groups, i.e. not under the thumb of the university and/or residency program at large? I'm wondering if it is possible to get the best of what I consider both worlds: High acuity and high volume but with the benefits of working for a democratic group (i.e. autonomy and salary).

I guess an alternate way to phrase this is: Are there any Level I community hospitals?

I don't think that these two things are mutually exclusive. You must be familiar with a system where the EM physicians at the level 1 centers are hospital employees or university employees. This is not the only way it is. For example at Detroit Receiving the EM physicians are not employees of the hospital, rather they have their own private group (MCES). MCES is a democratic group which pays well. I don't know what you mean by autonomy since no matter where you work you will ALWAYS be under review by the hospital board who will set up some rules you have to follow. I would expect that there are many more level 1 trauma centers then just DRH that have a private group staffing the ED.