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PounceMD

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Hello,

Thank you to all the members from medical student to attending for making this the excellent subforum that it is: a wealth of knowledge and global EM community.

I wish to start this conversation in line with the many other program-specific "residency threads" started by interns/residents on this sub.

The Riverside Community Hospital / UC Riverside program (RCH/UCR) will be welcoming its first cohort of residents this summer. I'm one of the starting interns.

With ERAS 2018 opening in approximately 1 month, I'll do my best to offer thoughts on what I know about the program, Riverside, California, etc.

Feel free to PM me if you prefer.

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How friendly is the program going to be for DO students?
 
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I'm not sure that as an intern you should be "formally start[ing] this conversation" and posting from a username that might imply you are doing this in some official capacity. Unless, of course, your residency asked you to do this.
 
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How friendly is the program going to be for DO students?

Hi DetectiveAlonzo,

DO applicants have indeed matched at other residency programs at RCH/UCR. Additionally, on my EM interview day, DO students were also represented. While the current cohort of incoming residents are MD graduates, it is also a relatively small class of 8. As more cohorts match to the program, more data will help with making your own conclusions. I understand that future data does not help you in your decision making now. Nevertheless, at present, I have no reason to believe that the program is anything less than friendly to DO applicants.

All the best and good luck with your cycle!

I'm not sure that as an intern you should be "formally start[ing] this conversation" and posting from a username that might imply you are doing this in some official capacity. Unless, of course, your residency asked you to do this.

Thank you for the feedback, brabbit2222! You made an excellent point regarding my initial username choice which hadn't previously occurred to me. In order to reduce the risk of confusion, I've implemented some changes to even better represent myself simply as a member of SDN continuing the tradition of residency threads which has years of precedence behind it. I aim to offer the SDN community a data point, one which from my searches has not been available until I created this thread. Again, I thank you for the assistance with warding off the confusion!

All the best!
 
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Any update on UCR? Got an invite but can't find much info on them.
 
Can you comment on any shortcomings or hiccups that you have encountered in the program with it being very new? I know that when some programs first get an EM residency that it can take years for relationships to be formed with surgery and other departments. Do residents rotate through any Level 1 trauma centers, or do you feel that training received at a level 2 is adequate? Very excited to be checking out your program this season!!
 
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Great questions! Keep them coming!

There are hiccups with being a new program.

For example, administration recently scheduled a 2pm-midnight swing shift in the ED. However, residents pointed out that this made it difficult to attend, stay awake, and pay attention at didactics Weds morning at 8am. Once this was pointed out to to our PD and APD, the schedule was changed. No more evening shifts Tuesday night. It took less than 12 hours to get results.

Some of our off service rotations are new. For example, we have a month of Ortho. Resident complaints revolve around that we are spending majority of time either in clinic or the OR. Minimal reductions during the month. Flipside? Our ED already does all their own reductions -- all the residents have at least a handful. Fractures. Dislocations. Ankles to hips to shoulders. So is the month of Ortho high yield? Administration is considering big changes as a result: shorten to just 2 weeks? Maybe discontinue it all together. Other rotations are on point. The EM program calls their own shots.

Another hiccup the hospital advertised the educational stipend as a certain value and the program budgeted it accordingly. However, the stipend was taxed, so there ended up being a disconnect in the budget. It won't be a mistake made twice.

Those are examples off the top of my head. Nothing too major really.

Our PD, APD, and Coordinator are ultra-focused on resident wellness. Our concerns and recommendations are implemented more times than not. I don't see that changing anytime soon because that's just who they are... it's their research focus - their passion.

Just a quick plug: we have a lot of special features at RCH/UCR.

We are the second highest volume ED in all of California (only surpassed by USC+LAC).

We have high acuity. The Level 1 vs Level 2 trauma center hasn't meant much. There's always someone in the trauma or resuscitation bays. A thoracotomy was done just a bit ago. People come in with gunshots, knives sticking out of them, bikers with their limbs literally ripped off their body. Head injuries. They come in. If they need transferred, they get transferred. Either way, you are getting the trauma experience and stabilizing patients in dire straits whether or not a neurosurgeon is somewhere in the hospital 24/7.

Also, we have among the best benefits of any residency in the country. 4 weeks vaca. Choose days off on EM rotations. ~$3600 education stipend (taxed ;)). Free parking. Free meals. Stock options. Retirement matching. Climbing gym discount. Free concierge service.

The program did a great job selecting the first cohort when it comes to meshing and dynamics. We're pretty close and have a great time together. As a matter of fact, tomorrow night you'll be able to find most of us heading to a SoCal amusement park for some scares... the residents not attending are those working.

We have wonderful attendings. Most are not only academic residency trained, but they've practiced and taught at SoCal academic hospitals. The experience is already there. Out of ~25 attendings, only one has rubbed a couple residents the wrong way. Not in a malignant way -- just personalities didn't mesh. Sure, one could think it is still a honeymoon period. But we are months deep at this point... and no bad interactions? That's saying something.

It's a wonderful learning environment in a new hospital with excellent opportunities.

Get excited about your visit with us because we are PUMPED to meet you.:soexcited:
 
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Dude (dudette? I don't EVEN know) - that was an ass-kicking post. Rock on!! I've been on SDN 15 years less a month (almost to the day), and a repetitious thing, almost to ennui, is admin from programs being deadly boring. I don't even know if they know how boring they are.

You ain't!!
 
Dude (dudette? I don't EVEN know) - that was an ass-kicking post. Rock on!! I've been on SDN 15 years less a month (almost to the day), and a repetitious thing, almost to ennui, is admin from programs being deadly boring. I don't even know if they know how boring they are.

You ain't!!

Haha, OP is a resident, not admin - But I agree, this post is excellent and makes me wish I'd applied. Going to share it with my friend who was fortunate enough to get an invite, for sure. I love seeing residents pop in to rep their programs on SDN and wish more places would do it!
 
Great questions! Keep them coming!

There are hiccups with being a new program.

For example, administration recently scheduled a 2pm-midnight swing shift in the ED. However, residents pointed out that this made it difficult to attend, stay awake, and pay attention at didactics Weds morning at 8am. Once this was pointed out to to our PD and APD, the schedule was changed. No more evening shifts Tuesday night. It took less than 12 hours to get results.

Some of our off service rotations are new. For example, we have a month of Ortho. Resident complaints revolve around that we are spending majority of time either in clinic or the OR. Minimal reductions during the month. Flipside? Our ED already does all their own reductions -- all the residents have at least a handful. Fractures. Dislocations. Ankles to hips to shoulders. So is the month of Ortho high yield? Administration is considering big changes as a result: shorten to just 2 weeks? Maybe discontinue it all together. Other rotations are on point. The EM program calls their own shots.

Another hiccup the hospital advertised the educational stipend as a certain value and the program budgeted it accordingly. However, the stipend was taxed, so there ended up being a disconnect in the budget. It won't be a mistake made twice.

Those are examples off the top of my head. Nothing too major really.

Our PD, APD, and Coordinator are ultra-focused on resident wellness. Our concerns and recommendations are implemented more times than not. I don't see that changing anytime soon because that's just who they are... it's their research focus - their passion.

Just a quick plug: we have a lot of special features at RCH/UCR.

We are the second highest volume ED in all of California (only surpassed by USC+LAC).

We have high acuity. The Level 1 vs Level 2 trauma center hasn't meant much. There's always someone in the trauma or resuscitation bays. A thoracotomy was done just a bit ago. People come in with gunshots, knives sticking out of them, bikers with their limbs literally ripped off their body. Head injuries. They come in. If they need transferred, they get transferred. Either way, you are getting the trauma experience and stabilizing patients in dire straits whether or not a neurosurgeon is somewhere in the hospital 24/7.

Also, we have among the best benefits of any residency in the country. 4 weeks vaca. Choose days off on EM rotations. ~$3600 education stipend (taxed ;)). Free parking. Free meals. Stock options. Retirement matching. Climbing gym discount. Free concierge service.

The program did a great job selecting the first cohort when it comes to meshing and dynamics. We're pretty close and have a great time together. As a matter of fact, tomorrow night you'll be able to find most of us heading to a SoCal amusement park for some scares... the residents not attending are those working.

We have wonderful attendings. Most are not only academic residency trained, but they've practiced and taught at SoCal academic hospitals. The experience is already there. Out of ~25 attendings, only one has rubbed a couple residents the wrong way. Not in a malignant way -- just personalities didn't mesh. Sure, one could think it is still a honeymoon period. But we are months deep at this point... and no bad interactions? That's saying something.

It's a wonderful learning environment in a new hospital with excellent opportunities.

Get excited about your visit with us because we are PUMPED to meet you.:soexcited:


Thank you for a great reply! Really looking forward to checking out your program!
 
Dude (dudette? I don't EVEN know) - that was an ass-kicking post. Rock on!! I've been on SDN 15 years less a month (almost to the day), and a repetitious thing, almost to ennui, is admin from programs being deadly boring. I don't even know if they know how boring they are.

You ain't!!

You're too kind! I've been reading your stuff on here for years. Means a lot. Thanks! :D

Haha, OP is a resident, not admin - But I agree, this post is excellent and makes me wish I'd applied. Going to share it with my friend who was fortunate enough to get an invite, for sure. I love seeing residents pop in to rep their programs on SDN and wish more places would do it!

Thanks for the feedback! I appreciate you giving us some rep. Sorry we won't have the pleasure of meeting you this cycle! :(

Thank you for a great reply! Really looking forward to checking out your program!

Looking forward to it! See you soon!

If anyone else has any other great questions don't hesitate to send them out!
 
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Thanks for your responses!

Can you comment on your own or your colleagues decisions for attending UC riverside over some of the more "big name/competitive" California programs? With a goal of becoming a well trained and competent EM physician who will likely work community medicine I have a strong interest in a program such as UC Riverside. Unfortunately, in my discussion with advisors and others have been told to favor interviews at the other "big name" schools over programs such as this due to the lack of reputation, questionable off service, general question marks of the program. I will be keeping my interview here because I personally have a strong interest in the program, but would be interested in the thoughts of you or others in your program. I was hesitant to originally post this because I in no way mean to say that this program is any less strong than others.

Also. If you could comment on life in Riverside in terms of housing and general lifestyle that would be fantastic. Thanks again for all your time.
 
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Thanks for your responses!

Can you comment on your own or your colleagues decisions for attending UC riverside over some of the more "big name/competitive" California programs? With a goal of becoming a well trained and competent EM physician who will likely work community medicine I have a strong interest in a program such as UC Riverside. Unfortunately, in my discussion with advisors and others have been told to favor interviews at the other "big name" schools over programs such as this due to the lack of reputation, questionable off service, general question marks of the program. I will be keeping my interview here because I personally have a strong interest in the program, but would be interested in the thoughts of you or others in your program. I was hesitant to originally post this because I in no way mean to say that this program is any less strong than others.

Also. If you could comment on life in Riverside in terms of housing and general lifestyle that would be fantastic. Thanks again for all your time.

These are real questions on a lot of applicants' minds! You're in good company.

It all comes down to knowing yourself and your long term goals.

Let me explain further while, hopefully, answering your questions...

In emergency medicine there's a lot of factors that go into getting a job (you know this). All those same factors + luck come into play for your dream job. Do you know what that dream job looks like? Probably not exactly at this level (I know I sure as heck didn't). With each passing month in the ED, that image will become more clear. However, I bet you do have some very good approximations of where you see yourself in 3-5-10 years. Community? Big name university? Small town? Big city? Purely clinical? Research? Administration?

If you see yourself with certainty going down the road of wanting to be a Professor at Denver, USC+LAC, Cinci... pumping out that research, etc. I have no reason to mislead you -- going to one of "those sorts" of programs indeed might serve you better to achieve that goal.

[That said, we do have research. In fact, one of our residents was selected to present their research from here at Cal/ACEP. Do we have the breadth of research that those programs above have? No. But, if you want to do projects, you certainly can with the program's full encouragement.]

If you want to be a community doc that can just about see and do it all, doing the years of residency at a community or county program where you actually have to do it all puts you in good order to achieve it. Want to work in an efficient community shop? Some programs will get you that much more exposure to "how things work in the community". By no means am I saying the academic university programs don't prepare residents for community, but do they prepare residents for the community EM experience better than community EM programs?

As a side note, a decent percentage of grads end up practicing in the region they did residency. If you MUST live in SoCal, try to do residency in SoCal. (Connections.)

Do you see yourself working purely clinical or implementing in some administration? If the latter, do you agree that it would behoove a resident to attend a program where they can get involved in the business aspects of medicine and ED administration from day 1?

Knowing yourself today will only benefit your decision tomorrow.

For myself and at least a few of my co-residents, we happen to have strong interests in administration. I remember on my interview day (wow, roughly a year ago now!), sitting in the interview with the PD and literally saying "I like to build things. I like making things. I want to keep doing it. You're the boss, but let me tell you I want to help you build this program."

Small chance you are going to match at Denver and "build the program". Chances are you aren't going to match at USC+LAC and play a pivotal role in drastically changing the way things are done. In all likelihood, you are not going to match at Cinci and look back and feel your hands starting intern year helped to mold it for what it is today (being there during the formative years helps).

Therein lies one of the beauties of a new program. If you like to build, if you want to be a go-getter, a leader, someone that helps make the path rather than follow one already laid out for them -- a new program is the type that potentially might quench that thirst.

I say "potentially" because each new program is different. Some departments might be less inclined to give their new residents big responsibilities. I can't speak for all new programs because I only know mine.

RCH/UCR gives autonomy and meaningful responsibility, I can say that with certainty because I've been living it.

Not all of my co-residents are interested in administration -- but all of them are interested in emergency medicine. All are interested in taking charge. All are interested in being an excellent physician.

RCH/UCR will permit for all those goals. We have the faculty. We have the patients. We have the acuity. We have the facility. We have the faith.

Your advisor wasn't crazy. There are wrinkles to be ironed out during those first several years. Some people like this type of ironing! And there are question marks: Off-service rotations, Consultant relationships, No senior residents (scary!).

I addressed the major hiccups in an earlier post, so I won't belabor that. I will say, that when your cohort matriculates, you will have a group of second years above you that are 100% interested in teaching and helping you during your intern year as much as possible. We're all in. It's not by chance. The administration literally made their match list last year selecting for this stuff -- so that's what they got.

Riverside housing is excellent. If you are single income, you will have a nice apartment in some of the nicest neighborhoods in the city. If you have a roommate or dual income, you can comfortably unlock very nice homes to rent. I'm taking 3 car garages and in-ground pools.

For residency, our lifestyles are pretty nice actually. For amenities of Riverside, it isn't the same city it was decades ago. There's a good supply of things to enjoy - from shows, to nature, to nightlife.

You made the right decision keeping your interview. How you decide to rank us compared to the other CA and "big name" programs depends on you. But at least that decision will be an informed one. And no one can fault you for that -- whatever you might decide.

Keep the questions coming! Fantastic!

PS: I write this late at night in an almost stream-of-consciousness fashion. Wording could be further perfected, but I think my overall points get across. There is not a universal best program. Your goal this cycle is to find the best program for you. RCH/UCR might be that program, it might not be. No matter where you go, you picked a good specialty and are going to do good things. Congrats! :nod:
 
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Hello,

In light of the upcoming interview season quickly arriving, I wish to briefly update my posts from a year ago. I am now a PGY-2.

My PGY-2 colleagues and I continue to be very pleased with our respective decisions to come to Riverside for training. Of course there are up's and down's with resident life. What I'm feeling right now is we do a lot of ICU during second year. While that is a tough schedule, it will ultimately pay-off at the finish line with a higher degree of comfort managing some of these ultra-sick patients.

At the end of my intern year, my intubation count approached 100. Not bad for 5 months of ED in a community shop. Other procedure counts (chest tubes, lines, PTA drainages, reductions, thoracentesis, paracentesis, vaginal deliveries) didn't go nearly as high as tubes -- but let's just say that we all, more or less, completed the "ACGME EM procedure requirements for the entirety of residency" during our PGY-1 year. It is nice to have volume. We have volume.

Our bed count is climbing to ~102 with brand new ED renovation slated to finish around Q1 2019.

We get a lot of sick folks. A lot of STEMI's. A lot of strokes (we are currently the only certified Thrombectomy-Capable Stroke Center on the West coast -- which translates to a lot of transfers from outside hospitals and EMS routing to our facility due to that title.)

There is a lot of trauma.

Numerous thoracotomies over the past year for crashing pts with penetrating trauma. I unfortunately wasn't on shift for any of them. Some of my colleagues were on shift. Thoracotomies as interns. Lucky ducks. There are many heavy traffic train tracks through Riverside, which means a lot of terrible accidents. We get trauma. Also apparently Riverside has won the title for "the worst drivers in the USA". Wear your seat belt. We get trauma.

We do not see a lot of bad burn patients. We are not a burn center.

As EM residents, our feedback has continued to be implemented. Last year was not a flash in the pan. There has been multiple tweaks and improvements happening on a monthly bases. Administration requests our feedback, we give it, change happens.

I thoroughly enjoyed personally meeting about 100 applicants during interview season last year. So many talented individuals heading into EM. We had a fantastic match and are blessed with 8 new interns which bring new experiences, perspectives, and passions to the ED. I could write a book about these ladies and gentlemen, but I'll spare you.

We interview from all over. To point out the geographic spread, we had interviewees from up northeast at Harvard, to down south at USF, to up in the pacific northwest from Oregon, down to the bottom of Cali in at UCSD. The blanket covered the entire US.

It's nice that there are no bad EM residencies in California. There are indeed a lot of name-brand giants. Our program is still the new kid on the block, and that will continue to keep some applicants away.

That said, come visit and see for yourself. If you're considering a 3-year residency program in Southern California, which brings both the opportunities of university-based academics with the luxuries of community programs, built on the tenets of resident wellness, clinical excellence, and leadership -- well, we are happily waiting to meet you this season!

Please don't hesitate to ask me any questions.

Thank you for your interest.

All the best!
 
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Great questions! Keep them coming!

There are hiccups with being a new program.

For example, administration recently scheduled a 2pm-midnight swing shift in the ED. However, residents pointed out that this made it difficult to attend, stay awake, and pay attention at didactics Weds morning at 8am. Once this was pointed out to to our PD and APD, the schedule was changed. No more evening shifts Tuesday night. It took less than 12 hours to get results.

Some of our off service rotations are new. For example, we have a month of Ortho. Resident complaints revolve around that we are spending majority of time either in clinic or the OR. Minimal reductions during the month. Flipside? Our ED already does all their own reductions -- all the residents have at least a handful. Fractures. Dislocations. Ankles to hips to shoulders. So is the month of Ortho high yield? Administration is considering big changes as a result: shorten to just 2 weeks? Maybe discontinue it all together. Other rotations are on point. The EM program calls their own shots.

Another hiccup the hospital advertised the educational stipend as a certain value and the program budgeted it accordingly. However, the stipend was taxed, so there ended up being a disconnect in the budget. It won't be a mistake made twice.

Those are examples off the top of my head. Nothing too major really.

Our PD, APD, and Coordinator are ultra-focused on resident wellness. Our concerns and recommendations are implemented more times than not. I don't see that changing anytime soon because that's just who they are... it's their research focus - their passion.

Just a quick plug: we have a lot of special features at RCH/UCR.

We are the second highest volume ED in all of California (only surpassed by USC+LAC).

We have high acuity. The Level 1 vs Level 2 trauma center hasn't meant much. There's always someone in the trauma or resuscitation bays. A thoracotomy was done just a bit ago. People come in with gunshots, knives sticking out of them, bikers with their limbs literally ripped off their body. Head injuries. They come in. If they need transferred, they get transferred. Either way, you are getting the trauma experience and stabilizing patients in dire straits whether or not a neurosurgeon is somewhere in the hospital 24/7.

Also, we have among the best benefits of any residency in the country. 4 weeks vaca. Choose days off on EM rotations. ~$3600 education stipend (taxed ;)). Free parking. Free meals. Stock options. Retirement matching. Climbing gym discount. Free concierge service.

The program did a great job selecting the first cohort when it comes to meshing and dynamics. We're pretty close and have a great time together. As a matter of fact, tomorrow night you'll be able to find most of us heading to a SoCal amusement park for some scares... the residents not attending are those working.

We have wonderful attendings. Most are not only academic residency trained, but they've practiced and taught at SoCal academic hospitals. The experience is already there. Out of ~25 attendings, only one has rubbed a couple residents the wrong way. Not in a malignant way -- just personalities didn't mesh. Sure, one could think it is still a honeymoon period. But we are months deep at this point... and no bad interactions? That's saying something.

It's a wonderful learning environment in a new hospital with excellent opportunities.

Get excited about your visit with us because we are PUMPED to meet you.:soexcited:

Stock options? Is UCR going to have an IPO? This I must understand....
 
Stock options? Is UCR going to have an IPO? This I must understand....

Hehe, it could have been worded better. To clarify, by "stock options", I meant residents have the option to get retirement benefits including stock purchasing discounts below market price.

...no puts and calls as far as I know.
 
Hehe, it could have been worded better. To clarify, by "stock options", I meant residents have the option to get retirement benefits including stock purchasing discounts below market price.

...no puts and calls as far as I know.

That makes more sense, but how do they offer stock below market price? Is this through a 401k? I am really curious as to how this works- I am not familiar with this as part of a benefit package. Do they offer a 401k match as well?
 
Can any current resident comment on the state of the program now that all classes are filled -- in terms of procedures, acuity of patients, how trauma is run? Also would like to hear about resident wellness and the general vibe amongst residents. Thanks in advance from someone very interested in the program.
 
The RCH program continues to thrive and has been accepting full classes each year from around the US. Procedures are plentiful, acuity is high and volume abundant.

I feel bad for the number of OSTEOPATHIC students who waste their time/money applying and interviewing with aspirations that they will be considered for acceptance. Without giving too much detail, HCA has a strong MD preference and discourages DO acceptance. Those in a position of decision seem to carry a similar bias. (As evidenced by alumni and current residents.) While unfortunate, it is fair to inform prospective DO applicants that their time will be better spent at other institutions that are willing to consider you fairly. Perhaps one day this will change to be more inclusive of all medical school degrees.

Nonetheless, the residents are well cared for, have good integration with educational opportunities and work closely with the local medical school.
 
Without giving too much detail, HCA has a strong MD preference and discourages DO acceptance. Those in a position of decision seem to carry a similar bias. (As evidenced by alumni and current residents.) While unfortunate, it is fair to inform prospective DO applicants that their time will be better spent at other institutions that are willing to consider you fairly. Perhaps one day this will change to be more inclusive of all medical school degrees.

Nonetheless, the residents are well cared for, have good integration with educational opportunities and work closely with the local medical school.
...which is funny since a lot of HCA's Florida residency programs started out as AOA/DO programs before the merger.
 
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Hello

OP here. About 5 years later.
Just to be complete, RCH/UCR remained a pleasure to complete residency at for PGY3. Looking above, it doesn't appear I commented that year.

My coresidents and I are all out and about practicing all over the country from PNW, to NorCal, to SoCal, to FL, to the NE.
The job market was tight for the second graduating class as it was in the height of the pandemic hiring freezes and the whole general EM job market debacle. Nonetheless, everyone got jobs from again the PNW, to SoCal, to AZ, to TX, to TN.

Third graduating class is on their way out the door and I can't speak to their job locations as I'm too far removed from the program...but I'm sure they will all do great. They were great as interns. I can only imagine how good they are now as PGY3's.

The acuity at RCH was astounding and, having been out around the country at a few hospitals now, I can say that none of these places have as sick as a population as Riverside. Good for the trainee. Bad for the general population of Riverside with impressive pathology.

Regarding procedures, no other program where I've been have anywhere near the procedural volume that was at RCH/UCR. I'm sure there are programs around the country that do more, but I haven't seen them yet. Full disclaimer, the program is larger now than when I was there. So the procedural volume might be somewhat diluted with more residents. That said, during my tenure there were interns getting dozens and dozens of tubes their intern year alone.

Regarding the osteopathic topic noted above, perhaps things have changed. But having been involved in the interview and ranking process, the DO degree was never a hard stop on any applicant's file. Being in SoCal, having great volume/pathology, and the wonderful faculty...we got a lot of applications. We didn't ever seem to fall far down on our rank list. While pedigree could give people a little boost for a number of reasons, it wasn't a red flag or anything being a DO.

I will say that unlike some of the other residency programs at the same hospital, we did not accept FMGs or IMGs.

There has been some leadership changes....
Our PD... now that I am out of the program and he has no authority over me...I can speak freely. Okay... here goes... deep breath.... He is a great guy! Sorry, I bet I had you going for a second. Tremendous leader and remained truly invested and fierce advocate for his residents. He has since climbed up the GME ladder as DIO of the hospital, but remains as Co-PD, shared position with our former APD (who is also a terrific, terrific guy). Our associate and assistant program directors are all amazing educators and mentors.

No issues with board certification. No issues with RCH itself being an HCA hospital. I have no complaints about the program as a graduate. I'd pick the same program if I had to go back in time and do it again. Don't get me wrong though, I'm glad residency is over and in the rearview!

PS: I don't respond to PM's because I'm not on SDN much at all. I'll check in every now and then. I see I have many PM's from years past that were never opened. Sorry about that. If you have questions, please just post them here.
 
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Anyone get the feeling HCA is getting/paying people to come outta the woodworks to post propaganda about the awesomeness of their programs? Year+ old posts necrobumped.

Litttttllleee odd that this is now the second program with posts recently about how awesome they are.
 
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Anyone get the feeling HCA is getting/paying people to come outta the woodworks to post propaganda about the awesomeness of their programs? Year+ old posts necrobumped.

Litttttllleee odd that this is now the second program with posts recently about how awesome they are.
That would be great if they would pay me to come out of the woodwork and comment.

Alas, I just got a push notification that someone commented on my thread from 5 years ago. I see the thread was due for an update and further clarification regarding osteopathic schools. And here we are.

I wouldn't consider it "propaganda" as you label it. How did you decide that? There is nothing political or misleading about my post or this thread. I am speaking from actual first-hand experience.

HCA does have some crappy residency programs. Is that something I need to say? Indeed they do. It is off-topic for this thread however.

Please let me know where to sign up to get paid for posting on SDN!
 
That would be great if they would pay me to come out of the woodwork and comment.

Alas, I just got a push notification that someone commented on my thread from 5 years ago. I see the thread was due for an update and further clarification regarding osteopathic schools. And here we are.

I wouldn't consider it "propaganda" as you label it. How did you decide that? There is nothing political or misleading about my post or this thread. I am speaking from actual first-hand experience.

HCA does have some crappy residency programs. Is that something I need to say? Indeed they do. It is off-topic for this thread however.

Please let me know where to sign up to get paid for posting on SDN!

When there is nothing but good things to say about the program, nothing whatsoever bad, everyones great, rainbows and sunshine, every intern is awesome, all leadership is great, super pathology, super procedures, my BS meter goes off.
 
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When there is nothing but good things to say about the program, nothing whatsoever bad, everyones great, rainbows and sunshine, every intern is awesome, all leadership is great, super pathology, super procedures, my BS meter goes off.

That's fair enough.

Some things that weren't so great...

Meth is a big big problem in the inland empire. You will likely have patient/s high on meth EVERY shift regardless of day of year or time of day. While this can make the work-up a bit more complex for whatever their actual CC is due to de facto deranged vitals, unreliable story, and usually plenty of comorbidies due to their ongoing drug use. While this is good for training purposes of residency, it can be dangerous for everyone. One resident did get hit, but luckily it wasn't too bad.

During my time of residency, we had free food. Totally free. Basically all you could eat at a cafeteria which was open like 20 hours per day. This WAS great sunshine and rainbows as you paint it, but to my understanding it is no more. I do not know if they have meal allowances or have to pay for meals now. Funny thing is that RCH also had a physician lounge with the catered meals and snacks 24/7 free for attendings. Now that I'm an attending none of the hospitals have free meals for attendings. My current hospital doesn't even have a physician lounge with snacks. These are university academic centers.

Some of the critical care attendings can be a bit rough around the edges. While I didn't have any memorable poor experiences or abuse, every year there would be an occasional complaint about XYZ in critical care verbally abusing residents. Again, not my first-hand experience, but heard about it. I do not know if those crit docs still work there or not.

Some of the hospitalist services will push back on admissions. Sometimes quite hard push back actually. While this is stressful as a resident, it makes for good training with knowing your patient and exactly why you are admitting them and how to say it in 10 different ways. There has not been pushback like that at other hospitals I have since been -- result is that it feels like a breeze now. But def not always fun at the time. I do not know if those hospitalists still work there or not.

We do not get a lot of cancer patients that come to the ED. During my time there I likely only had a couple cancer-related emergencies while on shift. This is largely because the overwhelming majority of patients with cancer get their cancer treatment at the other local hospital systems thus resort to going to those same hospital systems ED's or get directed to those ED's when they call their onc's office. I can't be mad at that I would highly recommend going to the system that has your onc records, treatment regimen, etc on hand vs an entirely new hospital if possible.

There aren't a ton of sick kids. Which I am happy about... But from a training standpoint, still need the sick kids exposure. This is partly because RCH has a tiny peds dept. There are several hospitals nearby with much larger peds depts and robust PICU's so the ambulance will often drive a little further to get to those destinations if they can (Loma Linda for example). Of course there is also the mega kids hospitals in the region like CHOC and CHLA. So as a result the residents do away rotations in PICU (including in house call) 8 weeks of it in my day... along with rotations at CHOC's ED and a rotation at CHLA. I was not a big fan of away rotations (learning new systems, being away from staff I knew, nurses not knowing or trusting the new face, etc). This likely won't ever change much because again there are great options for sick kids nearby and there just aren't that many sick sick kids. And the ultra-complex chronically sick kid with 100 previous PICU stays and a medication list with 30+ meds will always go straight to that same hospital for their ED care. We do get sick kids, codes, deaths... but just not anywhere near expected given our 120k annual ED volume.

We aren't a burn center. You will get burns if the ambulance doesn't go straight to Arrowhead. But if the patient needs burn center-level care... you are going to transfer at some point.

Outside of kids, burns, and cancer... nothing really gets diverted by the ambulance.
We have codes of all flavors. Gnarly traumas. You name it, they have it.

Otherwise, Riverside can get very hot in the summer. I remember it being 110 some days. It just wasn't comfortable to be outside sometimes.
 
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That's fair enough.

Some things that weren't so great...

Meth is a big big problem in the inland empire. You will likely have patient/s high on meth EVERY shift regardless of day of year or time of day. While this can make the work-up a bit more complex for whatever their actual CC is due to de facto deranged vitals, unreliable story, and usually plenty of comorbidies due to their ongoing drug use. While this is good for training purposes of residency, it can be dangerous for everyone. One resident did get hit, but luckily it wasn't too bad.

Having done med school and TRI in the IE (TRI and a lot of med school rotations at Arrowhead) and now working in South Florida... I'd take meth over cocaine and flakka any day of the week.
 
Having done med school and TRI in the IE (TRI and a lot of med school rotations at Arrowhead) and now working in South Florida... I'd take meth over cocaine and flakka any day of the week.
Are people still doing flakka? I thought that was something that was popular for a year or two but then basically died out 5 yrs ago. I have no personal experience treating people on it, just basing this on what I've heard from someone who used to work at Ryder.
 
Are people still doing flakka? I thought that was something that was popular for a year or two but then basically died out 5 yrs ago. I have no personal experience treating people on it, just basing this on what I've heard from someone who used to work at Ryder.

I still see it here in SW FL on occasion.
I work in a Level 1 White trash center.
 
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Hello

OP here. About 5 years later.
Just to be complete, RCH/UCR remained a pleasure to complete residency at for PGY3. Looking above, it doesn't appear I commented that year.

My coresidents and I are all out and about practicing all over the country from PNW, to NorCal, to SoCal, to FL, to the NE.
The job market was tight for the second graduating class as it was in the height of the pandemic hiring freezes and the whole general EM job market debacle. Nonetheless, everyone got jobs from again the PNW, to SoCal, to AZ, to TX, to TN.

Third graduating class is on their way out the door and I can't speak to their job locations as I'm too far removed from the program...but I'm sure they will all do great. They were great as interns. I can only imagine how good they are now as PGY3's.

The acuity at RCH was astounding and, having been out around the country at a few hospitals now, I can say that none of these places have as sick as a population as Riverside. Good for the trainee. Bad for the general population of Riverside with impressive pathology.

Regarding procedures, no other program where I've been have anywhere near the procedural volume that was at RCH/UCR. I'm sure there are programs around the country that do more, but I haven't seen them yet. Full disclaimer, the program is larger now than when I was there. So the procedural volume might be somewhat diluted with more residents. That said, during my tenure there were interns getting dozens and dozens of tubes their intern year alone.

Regarding the osteopathic topic noted above, perhaps things have changed. But having been involved in the interview and ranking process, the DO degree was never a hard stop on any applicant's file. Being in SoCal, having great volume/pathology, and the wonderful faculty...we got a lot of applications. We didn't ever seem to fall far down on our rank list. While pedigree could give people a little boost for a number of reasons, it wasn't a red flag or anything being a DO.

I will say that unlike some of the other residency programs at the same hospital, we did not accept FMGs or IMGs.

There has been some leadership changes....
Our PD... now that I am out of the program and he has no authority over me...I can speak freely. Okay... here goes... deep breath.... He is a great guy! Sorry, I bet I had you going for a second. Tremendous leader and remained truly invested and fierce advocate for his residents. He has since climbed up the GME ladder as DIO of the hospital, but remains as Co-PD, shared position with our former APD (who is also a terrific, terrific guy). Our associate and assistant program directors are all amazing educators and mentors.

No issues with board certification. No issues with RCH itself being an HCA hospital. I have no complaints about the program as a graduate. I'd pick the same program if I had to go back in time and do it again. Don't get me wrong though, I'm glad residency is over and in the rearview!

PS: I don't respond to PM's because I'm not on SDN much at all. I'll check in every now and then. I see I have many PM's from years past that were never opened. Sorry about that. If you have questions, please just post them here.

So what exactly were your procedure numbers by the end of residency?

Specifically intubations and chest tubes performed in the emergency department.

Riverside its probably the best corporate residency in the country right now but would honestly be surprised if your numbers were better than most established inner city county programs. For reference 100+ and 10+ are often considered the bare minimums for competency so assuming that you're really doing crazy high numbers of procedures I'd expect yours to be in the 200+ and 20+ range. I'm only mentioning this because right now lots of residencies are claiming to be doing tons of procedures but looking at the published literature tells quite a different story.
 
So what exactly were your procedure numbers by the end of residency?

Specifically intubations and chest tubes performed in the emergency department.

Riverside its probably the best corporate residency in the country right now but would honestly be surprised if your numbers were better than most established inner city county programs. For reference 100+ and 10+ are often considered the bare minimums for competency so assuming that you're really doing crazy high numbers of procedures I'd expect yours to be in the 200+ and 20+ range. I'm only mentioning this because right now lots of residencies are claiming to be doing tons of procedures but looking at the published literature tells quite a different story.
It’s interesting because there seem to be far fewer people getting intubated since covid. At least our internal system data from our hospital shows a significant overall decline in ED intubations across both residents and non-resident sites.

I wonder if this is because COVID had such a negative prognosis with intubation that we’ve been more selective in who we intubate in other cases.
 
It’s interesting because there seem to be far fewer people getting intubated since covid. At least our internal system data from our hospital shows a significant overall decline in ED intubations across both residents and non-resident sites.

I wonder if this is because COVID had such a negative prognosis with intubation that we’ve been more selective in who we intubate in other cases.

Could be related to increased use of HFNC. I know that, during residency (8-10 yrs ago) typically if someone was requiring a NRB we would just tube them. Now they get put on a HFNC and tubed in the ICU after a day or two (sometimes).
 
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