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For those of you playing along at home, this will be south Floridas 9th residency program in the Miami/Dade/Broward metro area, along side:

University of Miami/Jackson
Mt Sinai
Kendall regional (HCA)
Aventura (HCA)
Northwest Medical (HCA)
Memorial (Teamhealth I think?)
Broward Health (Teamhealth)
Florida Atlantic University

It will make 22 residencies in all in the state.

E45199E7-6003-4D5E-81DF-E8C63D92EDD5.jpeg
 
The Knife & Gun Club said:
For those of you playing along at home, this will be south Floridas 9th residency program in the Miami/Dade/Broward metro area, along side:

University of Miami/Jackson
Mt Sinai
Kendall regional (HCA)
Aventura (HCA)
Northwest Medical (HCA)
Memorial (Teamhealth I think?)
Broward Health (Teamhealth)
Florida Atlantic University

It will make 22 residencies in all in the state.
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Insane. I trained in FL and when I graduated there was USF, Jax, Gainesville and Orlando. I think that was it. There were ZERO programs in Miami.
 
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gutonc said:
Every person in any aspect of medicine should be worried about this. While the Post is crawling up Maimo's butt, this is not unique Maimo or NYC. It's everywhere.
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Agreed, Dr. gutonc.

But specifically for Maimonides, should a fourth year medical student take this into account when applying/interviewing for residency (i.e. all other things being equal, should I rank the program lower because the hospital might fail)? Is the situation analogous to Hahnemann University Hospital?
 
anonimoose said:
Agreed, Dr. gutonc.

But specifically for Maimonides, should a fourth year medical student take this into account when applying/interviewing for residency (i.e. all other things being equal, should I rank the program lower because the hospital might fail)? Is the situation analogous to Hahnemann University Hospital?
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Again...there's not much unique about Maimo's situation. If you're going to ask the question about them, you need to ask it about virtually every program/hospital in the country.
 
anonimoose said:
Thank you for your perspective.
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I am intimately familiar with the financials of 4 of the 7 hospital systems in my region (3 of those 4 and 5 of the 7 have residency programs of various sorts) and all 4 of the ones I know about have terrible financials…maybe not as bad as Maimo, but bad enough that everyone is freaking the f*** out right now. And we’re 3000+ miles away from Brooklyn.

I understand the concern re: another Hahneman, but that (and St Vincent’s in Manhattan a generation before it), but both of those were hospital specific mismanagement. Maimo’s problem may be an extreme case, but it’s emblematic of the economics of US healthcare in the post-pando times.
 
gutonc said:
Again...there's not much unique about Maimo's situation. If you're going to ask the question about them, you need to ask it about virtually every program/hospital in the country.
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I disagree. some places will be fine. For example Birgham lost $430+M, others also lost money. that speaks to a temporary issue. I dont know the specifics of maimonedes but losing money for a year or 2 isnt the same as being on the verge of financial ruin. See atlanta medical center. Yes everyone is hurting for money and yes that matters BUT its not all the same everywhere. Some systems have billions in reserves and some do not. If you go to a place without a lot of reserves i would be worried about closure and/or sale.
 
I'd say the past few years have been particularly hurtful for the panoply of US hospital systems, academic and community alike. Way more so than then general ebbs and flows of revenue cycles when things were in a relative steady state for the past few decades. That is true at my particular hospital system. Some will do fine. Some will get F'ed up. But as a whole they have lost money. It's like the S&P 500 this past year. A few stocks have done well, some OK..but many stonks have lost value.

If they have planned well they will survive but 2022 was a bleak year.
 
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thegenius said:
I'd say the past few years have been particularly hurtful for the panoply of US hospital systems, academic and community alike. Way more so than then general ebbs and flows of revenue cycles when things were in a relative steady state for the past few decades. That is true at my particular hospital system. Some will do fine. Some will get F'ed up. But as a whole they have lost money. It's like the S&P 500 this past year. A few stocks have done well, some OK..but many stonks have lost value.

If they have planned well they will survive but 2022 was a bleak year.
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Also while we stress about the upcoming Medicare cuts for physicians remember that over 50% of docs are now employed. Many by health systems. That’s a cut into their revenue and it’s not easy to cut someone’s pay in the setting of 7+% inflation.

Tough times ahead. Some of these systems have reserves and they will beg congress for a bailout of some sort. Others will die on the vine or sell.
 
I think it’s important to look at financial documents closely when analyzing the health of a hospital system. Almost all health systems are experiencing financial losses. Many large systems have experienced record losses. But you have to divide losses or profits into two categories, operating and nonoperating. Operating losses can be dangerous because they lead to erosion of reserves and reflect problems in the ability of a health system to generate long-term income. Nonoperating losses are unavoidable at the moment due to the state of the stock market.

A hospital like Maimonides has severe issues because they don’t have any reserves to fund operating losses and essentially have to either cut services and jobs or get a bailout from some governmental entity. With record budget shortfalls in NYC and a health system owned by the city with its own issues, I can’t really see a bailout occurring. There are political connections, particularly in the Orthodox Jewish community, but I don’t know where the money will come from.
 
Can someone shed light on why the hospital systems are losing so much money? Is it increased salary costs/FTE, decreased insurance payment, 8% inflation, mismanagement?

Covid and this yr has been a record years of inpatient admissions as it seems like any hospitals are at capacity for the past 3 years.

If it is increased Salary costs and inflation, then the only way to fix this is increase income which has to come from insurance carriers. Good luck on this. They seem to want to decrease payments every year and make it harder to collect.

If it is decreased insurance payments, well then we are essentially screwed and likely will turn into a single payer system. If carriers are making record profits and decreasing payouts, then eventually the Gov will need to take over.

If it is mismanagement, then let them burn.

If more hospitals start to go bankrupt, we are eventually going to have some form of governmental system. They are the only ones able to run anything at a perpetual loss and print money.
 
emergentmd said:
If more hospitals start to go bankrupt, we are eventually going to have some form of governmental system. They are the only ones able to run anything at a perpetual loss and print money.
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I'd say that's the end goal and it's intentional....but I'm not into conspiracies.
 
The cost of staffing has been astronomical. I have heard of large systems running their staffing costs at 60% above baseline. most hospitals run in the 2-3% margin range. Staffing is their biggest cost. While many hospitals are “full” I think this is a misnomer. Many of these “full” hospitals have beds that they closed due to staffing.
the cost of RNs is insane right now and the supply has become useless mid levels.
 
Thirty new doctors started their residency this week at Sutter Roseville Medical Center and the group is making hospital history.

The doctors were given their white coats during a special ceremony. This is the second class of resident doctors for internal medicine and surgery.

But 11 of them are the first group in the emergency medicine program. They include seven from Northern California.

There are also four women in a field which is about two-thirds men. One new resident was in the military when he decided he wanted to get into medicine.

Group of new doctors starting residency at Sutter Roseville Medical Center makes history
 
Mount Asclepius said:
You need to let up with these posts or at least put them in the right thread and not create a new thread every time.

Request to mods to move post to Emergency Medicine Wins!!! More Residency Positions
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No I think it should continue to be separate posts. This is the number one threat to emergency medicine and is what is going to end the specialty. Needs to be front and center so people can avoid this dumpster fire
 
EctopicFetus said:
It’s ok cause on FB everyone is saying how the workforce issues dont matter and welcome to the new sheep entering the slaughterhouse.

Clown World.
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To be fair, most of the FB EM group is going to be close to retiring when the crunch really sets in. And there's already a little of MLM vibe from mod, so they probably do feel like this is an unqualified win.
 
Did 21 really get banned for that?

Mods getting kickbacks from ACEP and CMGs confirmed.
 
Rekt said:
Did 21 really get banned for that?

Mods getting kickbacks from ACEP and CMGs confirmed.
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I normally don't reply to these type of comments, but that was actually pretty funny.

Speaking broadly, users can sometimes accumulate so many points that any additional points can cause them to be put on hold or banned. Users accumulate points for various reasons, and not all of them involve posts made in the Emergency Medicine forum.
 
southerndoc said:
I normally don't reply to these type of comments, but that was actually pretty funny.

Speaking broadly, users can sometimes accumulate so many points that any additional points can cause them to be put on hold or banned. Users accumulate points for various reasons, and not all of them involve posts made in the Emergency Medicine forum.
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How many points do i have? Or is that secret?
 
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southerndoc said:
I normally don't reply to these type of comments, but that was actually pretty funny.

Speaking broadly, users can sometimes accumulate so many points that any additional points can cause them to be put on hold or banned. Users accumulate points for various reasons, and not all of them involve posts made in the Emergency Medicine forum.
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Are you suggesting my high school principal wasn't full of it when he kept talking up the importance of the permanent record?
 
southerndoc said:
I normally don't reply to these type of comments, but that was actually pretty funny.

Speaking broadly, users can sometimes accumulate so many points that any additional points can cause them to be put on hold or banned. Users accumulate points for various reasons, and not all of them involve posts made in the Emergency Medicine forum.
Click to expand...
This is more transparency than in the first 10 years I was on SDN, combined.
 
southerndoc said:
I normally don't reply to these type of comments, but that was actually pretty funny.

Speaking broadly, users can sometimes accumulate so many points that any additional points can cause them to be put on hold or banned. Users accumulate points for various reasons, and not all of them involve posts made in the Emergency Medicine forum.
Click to expand...

I want to know if there is betting on point accumulation.

I know there is.... but I want to *hear about it*
 
Recently did a sub-I and interviewed here, here's what I thought/found:

Maimo: 3 year program, 8-12 hr shifts. Community program with high volume and acuity, diverse pathology, and extremely diverse patient population (good translating services available too). Only peds trauma center in Brooklyn. Not much trauma exposure in general but there is a 4-week shock trauma rotation in Baltimore during PGY2. Otherwise almost all rotations are in-house. Moonlighting starting PGY2, plus a lot of event medicine too. Currently very cramped ED during busy shifts but major expansion underway, so there will definitely be enough space for the incoming class. Cool elective opportunities during PGY3, including international and wilderness med electives. Ton of fellowship programs, including decent ultrasound and sim programs. Ancillary support is quite decent. Very non-hierarchical environment, close-knit group with extremely supportive culture. Everyone in the ED, including the younger attendings and fellows, goes out for drinks together every week. On the whole, really enjoyed my time here and gonna rank this place pretty high. Hope this helps!
 
WhatJobDoIPick said:
@Insight EM

Inquiring minds want to know:

1) Is this a POWERHOUSE residency?

2) how does it compare to the In N' Out program?
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From the PD’s letter to applicants:

“ Here, you will be immersed in a rich and diverse environment, caring for patients who reflect the full spectrum of humanity. This setting provides unparalleled opportunities to learn, innovate, and make a lasting impact. To put it simply, this is a program and place where I would choose to train in a heartbeat! As your Program Director, I want you to know I care about YOU- you as a person, and you as a physician.”

“Our mission is to grow you, shape you, and help you understand how you want your career footprint on emergency healthcare to land. I am excited to meet and work with students and residents who share our passion for making a difference. We are not just training emergency physicians; we are shaping leaders, healers, and advocates for the future of healthcare by modeling it ourselves.”

I can’t tell if it was written by ChatGPT or by that chick from Legally Blonde…either way, this is flat out embarrassing.
 
dozitgetchahi said:
From the PD’s letter to applicants:

“ Here, you will be immersed in a rich and diverse environment, caring for patients who reflect the full spectrum of humanity. This setting provides unparalleled opportunities to learn, innovate, and make a lasting impact. To put it simply, this is a program and place where I would choose to train in a heartbeat! As your Program Director, I want you to know I care about YOU- you as a person, and you as a physician.”

“Our mission is to grow you, shape you, and help you understand how you want your career footprint on emergency healthcare to land. I am excited to meet and work with students and residents who share our passion for making a difference. We are not just training emergency physicians; we are shaping leaders, healers, and advocates for the future of healthcare by modeling it ourselves.”

I can’t tell if it was written by ChatGPT or by that chick from Legally Blonde…either way, this is flat out embarrassing.
Click to expand...
Translation: “CMG needs more slaves because too many are escaping to pain, CC, retirement and all too soon…sleep medicine. We need more blue pill residents to help us keep compensation down and fill our dumpster fire EDs with warm blood bags. All your base are belong to us.”
 
Last edited:
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Kind of amazing- skip the Match and just apply via SDN

I knew this hospital well by reputation (notorious?) when all their sick patient would be transferred all delayed and messed up to County and other trauma shops in Chicago.

Program Director went to Saint James School of Medicine which I'm sure is the Harvard of British Overseas Territory medical schools, clearly backed by private equity- why do we keep paying money to ABEM to do non-sense quizzes every year when they authorize this kind of nonsense?

​

 
I’m not worried about places like this. The people coming out of here will not be competent. The world needs urgent care docs.
 
hoot504 said:
I’m not worried about places like this. The people coming out of here will not be competent. The world needs urgent care docs.
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Even worse. They'll refer completely unnecessary things to your ED such as healthy 18-year-old with normal vitals, well-appearing, but flu-like symptoms for "rule out meningitis".
 
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