Question for Quinn

[tjmDO]

Hey Quinn,

I am a second year at AZCOM and wanted your opinion on DO EM resedencies. Which ones are the best? Oh and why did you choose an allopathic residency?/or is it? I am still trying to decide if I want allopathic or osteopathic.

Thanks

tjmDO

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[DrQuinn]

Thanks for the personalized thread, although I think you might have gotten a better response had you named it "DO vs MD EM residencies," but then again I'm sure you'll get a lot of trollers looking to see what sexual question you may have asked...

I originally had planned on going to a DO residency, mainly because I thought it was impossible for a DO to land an MD EM residency, since, to be honest, we can be viewed as the underdog in the application process, and EM is somewhat competitive. I had this idea up until about the end of my second year, when I realized that close to 8% of all MD EM residents are in fact DOs.

That being said, there are about 20 or so DO EM residencies. Some better than others. I can't really comment on which are the best ones... that should be revealed to you upon your interview there. Residency is more of a personal decision, IMHO, than of a "US News Ranking." I liked a smaller program in a big city, so USF/TGH is perfect for me (6 residents a year, 50-70k visits a year, lots of penetrating trauma if that's what you like). Other programs have fewer visits but have varying pathology. Its up to you to decide what you look for in a residency.

As a second year medical student you are a big early in the game. Concentrate on classes, do well on boards, then look around your third year. Do a few EM electives. Hang out in the ER every once in a while.

Now down to the nitty gritty. I would think that the best DO EM program is Albert Einstein Medical Center in Philly, PA. Dually accredited, 4 year program. Excellent training. I rotated there. It wasn't for me but the training there is top-notch, very high acuity. Consistently perform well on their exams. Their fourth year residents are ultra-smart, but they should be since most MD EM residencies are three years...

Q< DO

 

[bullhorn]

quinn, would you say that the four year programs teach residents more administrative duties? i am a premed applying, most definitely interested in EM and my first choices are DO schools. However, I am also interested in health administration and would hope to one day be running an ER... alot of people have suggested doing a DO/MBA or DO/MPA program to gain those administrative/business skills. Some others say they learned alot on the job during residency without the extra degree. What are you thoughts as a PGY-1 and knowing some differences between 3 year and 4 year EM programs?

 

[Sessamoid]

Originally posted by bullhorn
quinn, would you say that the four year programs teach residents more administrative duties? i am a premed applying, most definitely interested in EM and my first choices are DO schools. However, I am also interested in health administration and would hope to one day be running an ER... alot of people have suggested doing a DO/MBA or DO/MPA program to gain those administrative/business skills. Some others say they learned alot on the job during residency without the extra degree. What are you thoughts as a PGY-1 and knowing some differences between 3 year and 4 year EM programs?

I'm not Quinn, but probably can offer an opinion worth more than a shake of salt. Four year programs will typically graudate clinically stronger residents than 3 year programs simply by dint of volume of information available a training period 33% longer. There are usually some extra administrative duties during the fourth year of 1234 programs, but these are generally not large AFAICT. I am a graduate of a 3 year program, so I can only speculate.

As far as becoming a medical director of an ED, nothing will prepare you like the real world. Residency sure won't. I doubt an MBA will make a huge difference, though I could be wrong especially if you have no business background at all. I came from a financial analysis career before this so I may be biased. The running of an ED is peculiar thing with many details that are unique as a business. Most of the business aspects of running the ED will fall to the hospital administration, which is fine with me as those are to me the least interesting parts of running the ER. Those jobs will generally be done by either nurse managers (who will be paid much less than you as a physician) or some paid suit (who will also be making much less than you). The business administration of the ED isn't a profitable venture for most of us emergency physicians, so we don't "own" that turf.

 

[normalforce]

Nor am I Quinn, but I want to add something about the MBA credential...

I am at UHS in the 4 year DO/MBA dual degree program. As a third year nearly finished with the MBA didactic curriculum, I can not tell you how much more prepared I am for leadership, leading teams successfully, and general management type of stuff. My advice to you is that if you have any interest in the business of medicine or in administrative medicine, GET YOUR MBA NOW. Do it while you have the time to do it. (seems a little paradoxical to say that you have the time now, but trust me, now is better than latter).

Check out the UHS website and go to Academics then DO/MBA for more info. www.uhs.edu

Good Luck,

normalforce

 

[Sessamoid]

The MBA is of unquestionable value if you really want to get into the business administration side of health care, and it can provide an interesting option in case you get tired of clinical medicine later in your career.

I don't think it adds a lot in your bid to become a medical director of an ED though. Most of that job is not about business per se, but more about the operational efficiency of the ED, political dealing in the hospital staff and nursing, and arguing with the hospital administration about what is both appropriate and affordable (in this the MBA might be somewhat useful, but most of it is things you need to learn on the job anyway). The vast majority of ED medical directors I've known are not MBAs, and in fact I can't think of one who is an MBA off the top of my head. Not having the MBA will not be a deterrent if medical direction is what you are interested in. But as I said, it may have other benefits if that's your leaning.

 

[bullhorn]

thanks normalforce and sessamoid....i ama person that likes to make 5-yr plans, so i know i have some time but i always say it doesn't hurt to contemplate all my options.


normalforce, i have definitelyheard the 'do it now' argument alot. i hear this is the best time to get a mba or mph or mpa if you are pursuing a medical degree. thanks for the website, i will definitely check it out.

 

[bullhorn]

Also i noticed quinn said that the em residency at albert einstein in philly was dually accredited. i am wondering why there aren't other programs like this. is this an anomaly or are their others?

 

[doc1]

The EM Program at Michigan State in Lansing is a dually-accredited residency program. They take 5 M.D.'s and 5 D.O.'s in each class. 4/5 DO's complete tracking internship programs at either of the two hopitals in town we rotate through. I am a first year resident and so far think the program is great! As a first year we do 14 shifts per ED rotation, which has left me with plenty of time for reading and enjoying my life.

 

[grouptherapy]

Originally posted by bullhorn
quinn, would you say that the four year programs teach residents more administrative duties? i am a premed applying, most definitely interested in EM and my first choices are DO schools. However, I am also interested in health administration and would hope to one day be running an ER... alot of people have suggested doing a DO/MBA or DO/MPA program to gain those administrative/business skills. Some others say they learned alot on the job during residency without the extra degree. What are you thoughts as a PGY-1 and knowing some differences between 3 year and 4 year EM programs?

don't do the mba (with an emphasis on hospital administration) unless you want to be hospital president or ceo. to run the ED, you can do a one year fellowship

 

[DrQuinn]

Originally posted by bullhorn
Also i noticed quinn said that the em residency at albert einstein in philly was dually accredited. i am wondering why there aren't other programs like this. is this an anomaly or are their others?

I think its great that a question was posed, and answered far better than I could have in my absence. Gotta love those 12 hour shifts in the ED (non-fast track). Woowee are my feet tired.

Your original post was answered quite well...

there are few dually accredited DO/MD EM programs. You have to not only deal with the MD RRC (a beast unto itself) but also the AOA-version, so you are a slave of both, as well as under the microscope of both (both have different views on what should be taught). I.E. pain in the arse for the program. Besides Einstein (which puts out excellent graduates), and one or two in Michigan, I don't know of any others.

As a pre-med, don't sell yourself short. Who konws you could make it into an MD school and laugh all the way to the figurative bank (NRMP match). As a DO EM is wide open, 8% of all EM residents are DOs, far greater %age than ortho or any other competitive specialty.

Q, DO