Residency Review Discussions

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Not sure what you meant by this but different programs def work diff hours. There are places that work 22 12's a month as interns and I interviewed at a place that does 20 8s a month as interns. Big difference in hours. At u of A we do 20 9s every 4 weeks.
A program that does 22 12's per month is in clear violation of RRC work hour limitations, which specifically limit ED time to 60 hours/week (including the 5 hours of conference time).

Members don't see this ad.
 
So my girlfriend isn't opposed to Cinci anymore. Hmmm.....maybe I nagged her enough to start considering it :D

Damn! I need people to not like that city! It helps me out! :D
 
Damn! I need people to not like that city! It helps me out! :D

Haha, we'll see. I think there are still enough people who hate that city to want to rank it high.
 
Members don't see this ad :)
A program that does 22 12's per month is in clear violation of RRC work hour limitations, which specifically limit ED time to 60 hours/week (including the 5 hours of conference time).

Hmm I thought it was 65 total so you could work 22 12s.. I believe Kings County does this. Anyways at the bare minimum I would rather do 20 9s (with 1 hour overlap) than 12s which often become 14s...

Cook County does 20 8s in a month..
 
PM me if you're interested in posting reviews anonymously.
 
For those interested, I'm going to try to see if it's OK with SDN if I just give out the password to this profile by PM or just in a post so that others can post anonymous reviews on this forum. Obviously it would be on the honor system, but flamers are really mythical beasts of legend, right?

Ideally this would allow people to give their most honest opinions on programs and alleviate that fear in the back of your head that there are PD's lurking out there WHO AND KNOW WHERE YOU LIVE...

I'll see if Quinn or the other moderators think it's ok--stay tuned. It'll be my Christmas present to SDNer's.

I think that would definitely increase the number of reviews.
 
Just finished interviewing at Harbor/UCLA today. One word...awesome! I'm gonna be putting up reviews for Highland and Harbor over the next few days. I gotta sort out a few tidbits and get my info together. Lets get more reviews!
 
Just finished interviewing at Harbor/UCLA today. One word...awesome! I'm gonna be putting up reviews for Highland and Harbor over the next few days. I gotta sort out a few tidbits and get my info together. Lets get more reviews!

Ahem, check your PM box.
 
Just finished interviewing at Harbor/UCLA today. One word...awesome! I'm gonna be putting up reviews for Highland and Harbor over the next few days. I gotta sort out a few tidbits and get my info together. Lets get more reviews!

Maybe that city won't play much of a role after all? Maybe for the both of us, I think my girlfriend was being nice and didn't really mean it??? We'll see...

Glad you're loving multiple options!
 
Maybe that city won't play much of a role after all? Maybe for the both of us, I think my girlfriend was being nice and didn't really mean it??? We'll see...

Glad you're loving multiple options!

Haha...we shall see. In all honesty though, I think I'd be happy at any of the programs I've interviewed at. Ugghhh...making a ROL is gonna be tougher than I thought.
 
Haha...we shall see. In all honesty though, I think I'd be happy at any of the programs I've interviewed at. Ugghhh...making a ROL is gonna be tougher than I thought.

Tell me about it. I feel like i'd be happy at any of them too even though I have some favored over others. Separating out the top 5 or 6 is going to be tough because they can all be my #1! Ahhhh!!!!!!
 
Members don't see this ad :)
I'm going to toss some more reviews out there over the next several days... several of them are programs that have already been reviewed, but I figured an additional perspective couldn't hurt.

Similarly, if anyone else wants to add their thoughts on programs that have already been reviewed (particularly UNC, Christiana, & Pittsburgh) please chime in.
 
Any reviews on UMDNJ-Newark?
 
It is currently a 3 year program, but they will be changing to a 4 year program. They stressed that a lot because they feel that it’s the way EM is going.

Just curious.... did they say why they think that this is the way EM is going? I honestly haven't heard this from anyone else or any other organization.
 
Just curious.... did they say why they think that this is the way EM is going? I honestly haven't heard this from anyone else or any other organization.

Most PDs and Chairmen in EM I've talked to think a fellowship is becoming more and more necessary in order to become successful in academics or EM leadership. My understanding of Hopkins is that it strives to become an ultra-academic EM program, and as such plans to devote the 4th year of their residency to an integrated fellowship. Similarly, the new residency program beginning in 2008 at UCSF will be a 1-4 format and have an emphasis on research and academics.
 
Most PDs and Chairmen in EM I've talked to think a fellowship is becoming more and more necessary in order to become successful in academics or EM leadership. My understanding of Hopkins is that it strives to become an ultra-academic EM program, and as such plans to devote the 4th year of their residency to an integrated fellowship. Similarly, the new residency program beginning in 2008 at UCSF will be a 1-4 format and have an emphasis on research and academics.


One new program becoming 1-4 and one adding a year does not make a national trend. The vast majority of programs are 1-3. The idea of an integrated fellowship is nice, but an extra year is not necessary for this. Point in fact: our program is a 1-3 and 70% of our grads end up having a similar experience (its called a 'niche' program). EMS, research, ultrasound, etc all can be done in a 3 year program.

By the time I was half way through my second year, I had over 800 ultrasound scans (it was what I was planning on doing) and one abstract. I quickly realized I didn'tn want to do a fellowship (outside of administration, what would have been the point). I ended up switching to research and got protected time from my program to develop this niche. Many others have done similar things in Disaster, U/S, Medical student education, administrative. Adding an extra year can be a good thing, however, it doesn't replace a fellowship.

Look closely at how the extra year is being spent: are you actually devoting an equiv 12 months developing your 'niche'? or is it spent on off services?

If you really want to do academics, you will probably need a fellowship so the time becomes an important point.

Just something to think about. :)
 
Look closely at how the extra year is being spent: are you actually devoting an equiv 12 months developing your 'niche'? or is it spent on off services?

If you really want to do academics, you will probably need a fellowship so the time becomes an important point.

Just something to think about. :)

Maybe I'm missing something, but I think you and I are saying the same thing...

The national trend is that a fellowship is becoming more and more important for an academic career. The ideal route (for me at least) would be a 1-3 followed by a fellowship. That way you retain some flexibility if you change your mind about going into academics vs. community, and if you do decide to pursue a fellowship you do so after 3 years rather than 4.

The new curriculum at Hopkins seems to be oriented toward ensuring that more of their residents go into academics. Thus, my understanding is that they are going to keep the curriculum nearly identical to the current 1-3 format, and then simply add a 4th year in which you are required to complete (or begin, in the case of 2-year fellowships) one of their 11 fellowships. Nice if you're certain that you're headed for academics, but limits your flexibility somewhat.
 
Hmm I thought it was 65 total so you could work 22 12s.. I believe Kings County does this. Anyways at the bare minimum I would rather do 20 9s (with 1 hour overlap) than 12s which often become 14s...

Cook County does 20 8s in a month..

EM rules are 60 hrs clinical, 72 hrs all duties. at least as much time off between shifts as shift lengths etc.

When off service, follow ACGME rules (80 hrs, 1 day a week off both averaged over a month, etc.)
 
Most PDs and Chairmen in EM I've talked to think a fellowship is becoming more and more necessary in order to become successful in academics or EM leadership. My understanding of Hopkins is that it strives to become an ultra-academic EM program, and as such plans to devote the 4th year of their residency to an integrated fellowship. Similarly, the new residency program beginning in 2008 at UCSF will be a 1-4 format and have an emphasis on research and academics.

Thanks Wahoo, that makes a little more sense. I guess I was thinking about the traditional 1-4 programs and not the 1-3 + fellowship route. As someone who's interested in academics and who has talked to alot of people about a career path in this area, I have heard that a fewllowship can really open up alot of doors in the academic community. And I think that you and roja are basically saying the same thing, just different ways.
 
EM rules are 60 hrs clinical, 72 hrs all duties. at least as much time off between shifts as shift lengths etc.

When off service, follow ACGME rules (80 hrs, 1 day a week off both averaged over a month, etc.)

Thanks BKN...
 
Maybe I'm missing something, but I think you and I are saying the same thing...

The national trend is that a fellowship is becoming more and more important for an academic career. The ideal route (for me at least) would be a 1-3 followed by a fellowship. That way you retain some flexibility if you change your mind about going into academics vs. community, and if you do decide to pursue a fellowship you do so after 3 years rather than 4.

The new curriculum at Hopkins seems to be oriented toward ensuring that more of their residents go into academics. Thus, my understanding is that they are going to keep the curriculum nearly identical to the current 1-3 format, and then simply add a 4th year in which you are required to complete (or begin, in the case of 2-year fellowships) one of their 11 fellowships. Nice if you're certain that you're headed for academics, but limits your flexibility somewhat.



An interesting plan. same three years and then esssentially gauranteed a spot in one of thier residencies? I'll be curious to see how they end up doing this. A really uniqe idea.
 
Trying to narrow down my last few interviews (yeah, I'm getting tired and have some places I love already). Dr. Will, thanks for the great review on harbor.

I'd love to know more about: UC-Davis, Highland, OHSU, New Mexico, UCSD. Thanks to everyone writing reviews.

To those of you not posting and just reading reviews, I don't care about your lame excuses for not posting.
 
Trying to narrow down my last few interviews (yeah, I'm getting tired and have some places I love already). Dr. Will, thanks for the great review on harbor.

I'd love to know more about: UC-Davis, Highland, OHSU, New Mexico, UCSD. Thanks to everyone writing reviews.

To those of you not posting and just reading reviews, I don't care about your lame excuses for not posting.

I'm very likely going to post the Highland one up at some point tonight. I guess I can offer up a UC Davis one as well, since I spent a month there. In short, it's an awesome program.
 
I've got a similar dilemma as you crewmaster. I've gone on 10 interviews and am more than comfortable matching at most of them, but many are in california and there is no guarantee of a match. I was hoping to not go on anymore interviews, but may just take some more money out of financial aid and go to two or three out of: ohsu, new mexico, emory, irvine, loma linda, or olive view.

any thoughts? didn't see reviews of any of these places . .
 
Most PDs and Chairmen in EM I've talked to think a fellowship is becoming more and more necessary in order to become successful in academics or EM leadership. My understanding of Hopkins is that it strives to become an ultra-academic EM program, and as such plans to devote the 4th year of their residency to an integrated fellowship. Similarly, the new residency program beginning in 2008 at UCSF will be a 1-4 format and have an emphasis on research and academics.

This is absolutely NOT a consensus statement. It's not like you can't be successful in academics or EM leadership if you don't do a fellowship. There are many examples, in fact the vast majority of those in leadership positions in academics are not fellowship trained. Plus, of the 4 boardable sub specialties in EM, do you see how any of them prepare you specifically for 'leadership' or for being an 'academic'?

Wanna be an ultrasound director? Yeah, I think you need a fellowship! But if your goal is to assume a leadership role in academic emergency medicine, the path does not necessarily go through fellowship.

As for the UCSF residency, they can say all they want about having a four year residency so that they can focus on "research and academics" but until I see a rough plan of their residency curriculum consistent with this aim (i.e. not just stacked with more off service) I wouldn't give it much credence. Hell, they don't even have their PD yet!

Do 4 years if you want. Do a fellowship if you want. But if your #1 reason for doing either is because you want to be a "leader in EM" or because someone told you it is a sine qua non to being successful in academics, you've been getting bad advice.
 
...It's not like you can't be successful in academics or EM leadership if you don't do a fellowship. There are many examples, in fact the vast majority of those in leadership positions in academics are not fellowship trained. Plus, of the 4 boardable sub specialties in EM, do you see how any of them prepare you specifically for 'leadership' or for being an 'academic'?... Do 4 years if you want. Do a fellowship if you want. But if your #1 reason for doing either is because you want to be a "leader in EM" or because someone told you it is a sine qua non to being successful in academics, you've been getting bad advice.

Although I do agree with you that a fellowship or four years is not necessary to achieve academic success, there does appear to be a trend toward recruiting those with four years of residency and/or fellowship trained applicants. There was an article recently by the Mayo folk that demonstrated an increasing need for fellowship-trained emergency physicians in academia.

One cannot look at the current status of successful academic emergency physicians because those guys ushered in residency training. During the beginning of their careers, there were very few residencies, and even less fellowships. Ultrasound, research, and other fellowships simply didn't exist during that time.

It is likely that 5-10 years from now, fellowship training will become an increasing desire among academic directors. With all things equal, if one person has fellowship training (research, administration, EMS, ultrasound, etc.) and the other doesn't, it is likely the fellowship-trained individual will be hired instead of the one without the fellowship (assuming all others things such as research status, recommendations, etc. are equal).

As I said before, I agree with you that fellowship training or four years of residency is not necessary for academic success. However, they will make your life easier trying to secure the position you want. Without either, you may find yourself needing to be more flexible about where you are willing to work.
 
This is absolutely NOT a consensus statement. It's not like you can't be successful in academics or EM leadership if you don't do a fellowship. There are many examples, in fact the vast majority of those in leadership positions in academics are not fellowship trained. Plus, of the 4 boardable sub specialties in EM, do you see how any of them prepare you specifically for 'leadership' or for being an 'academic'?

Wanna be an ultrasound director? Yeah, I think you need a fellowship! But if your goal is to assume a leadership role in academic emergency medicine, the path does not necessarily go through fellowship.

As for the UCSF residency, they can say all they want about having a four year residency so that they can focus on "research and academics" but until I see a rough plan of their residency curriculum consistent with this aim (i.e. not just stacked with more off service) I wouldn't give it much credence. Hell, they don't even have their PD yet!

Do 4 years if you want. Do a fellowship if you want. But if your #1 reason for doing either is because you want to be a "leader in EM" or because someone told you it is a sine qua non to being successful in academics, you've been getting bad advice.


Agreed that it is not the consensus. However, I've been interviewing all over the country the past couple months, and I've discussed fellowships with nearly all the PDs and chairmen I've met. Granted, I've mostly been interviewing at pretty academic places, but about 2/3 of them have said that they feel a fellowship will become a virtual necessity for an academic career in EM within the next 5-10 years.

As for UCSF, I agree -- as a new 4-year program they'll certainly have to prove to potential applicants that the extra year is worth it. I am skeptical, but we'll see what happens. They do have their PD however -- Susan Promes is leaving Duke for the position.
 
This is something that we can all debate forever. I personally like the 3 year + fellowship route over the traditional 4 year route because you can say you are an "expert" within that niche of EM. Coming out of just a 4 year program, all you can really say is that you have 1 more year of experience and maybe a little more exposure to a niche of EM than a 3 year graduate but you can't say you are an "expert." I'm simple and I like my view of the topic. :D

When I was at Hopkins, they stressed the 4th year would be a "required fellowship" because of their philosophy of developing leaders in the field. I say that the individual decides if they want to become a leader. Many of the leaders in EM today didn't even do a residency in EM, and more still completed 3 year residencies.
 
Be wary of assuming that four years equals a year of experience. What counts is the total # of months in the ED. (ie some 3 year programs have more than 4 year programs). Not that time on extra off service months isn't a learning experience, but this comes down to a philosophy. And how you want to spend an extra year of your life. For some four years is what they need/want. For others its not. Its a personal thing. But 4 years doesn't automatically mean more EM experience.

If you want to go academics, getting a niche doesn't hurt, however you get it.
 
Agreed that it is not the consensus. However, I've been interviewing all over the country the past couple months, and I've discussed fellowships with nearly all the PDs and chairmen I've met. Granted, I've mostly been interviewing at pretty academic places, but about 2/3 of them have said that they feel a fellowship will become a virtual necessity for an academic career in EM within the next 5-10 years.

As for UCSF, I agree -- as a new 4-year program they'll certainly have to prove to potential applicants that the extra year is worth it. I am skeptical, but we'll see what happens. They do have their PD however -- Susan Promes is leaving Duke for the position.


Well, I see your point about what the PDs THINK will be a "virtual necessity" in 5-10 years. But this illustrates a real problem to me: It will be a virtual necessity not because you acquire any particular aspect during the fellowship that will make you a better academician, but because "everyone else has one, so you need one to".

Once again, I agree wholeheartedly with the idea that anyone who develops a "niche" is inherently more marketable. But fellowship training does not make you anymore or less able to be successful in academics per se. It is this ill-defined concept that fellowship completion = necessity for job that will be the driving force for it to be a "necessity"... it's a self-fulfilling prophecy.

Now, show me a fellowship that has, as one of its central premises, significant time devoted to teaching and administrative duties, as well as whatever the niche area you are in, AND leads to board certification, then I think you've got the potential to make a claim for the value of a fellowship in getting a job in acadmics.

But as it stands now, fellowship training, at least as far as the specific value of preparing you for an academic job, is only going to be a necessity because of the insecure perspective of residents who think that a fellowship is absolutely necessary and, by extension, that completion of a fellowship is entitlement to an academic job.
 
Agreed that it is not the consensus. However, I've been interviewing all over the country the past couple months, and I've discussed fellowships with nearly all the PDs and chairmen I've met. Granted, I've mostly been interviewing at pretty academic places, but about 2/3 of them have said that they feel a fellowship will become a virtual necessity for an academic career in EM within the next 5-10 years.

As for UCSF, I agree -- as a new 4-year program they'll certainly have to prove to potential applicants that the extra year is worth it. I am skeptical, but we'll see what happens. They do have their PD however -- Susan Promes is leaving Duke for the position.
\

And oh yeah, I know that Promes took the job, but last I heard she is still the PD at Duke (and is until the summer), so its not like they have a PD working full time on defining the residency yet.
 
Most PDs and Chairmen in EM I've talked to think a fellowship is becoming more and more necessary in order to become successful in academics or EM leadership. My understanding of Hopkins is that it strives to become an ultra-academic EM program, and as such plans to devote the 4th year of their residency to an integrated fellowship. Similarly, the new residency program beginning in 2008 at UCSF will be a 1-4 format and have an emphasis on research and academics.

I've been fairly well received in the academic job hunt with a three year residency. It may be beginning to trend toward four year and/or fellowship, but I don't think that it is "there" yet...

- H
 
I know Dr. Will rotated here so he probably knows more than I do. Feel free to add comments. Overall- really really liked this program.

Residents: There was a good turnout the night before for dinner and during our interview day, and everyone seemed very nice and laid back. They all stressed how happy they were with their program and how well prepared they would be when they graduated. Seemed like most are the west coast originally, but there were some people from other areas of the country.

Faculty: The PD is very nice and personable, and I think he does everything he can to make the residency better. In short, I would love someone like him to be the PD at whatever program I end up at! The other faculty I interviewed with were cool and approachable. The faculty produce a lot of research every year. The PD was quick to point out that he feels that a lot more faculty are on at one time as compared to other programs, so there is more time for teaching.

Facilities/Ancillary services: The ED is pretty standard, divided into three areas according to pediatrics/acuity. It isn't super big, maybe around 40 beds, and they see around 60,000 per year. There is construction for a new surgery/emergency pavilion currently underway and it is supposed to be done in 2008. The new ED will be bigger, 60 beds or more. You are not starting your own IVs all the time or taking pts to xray.

Curriculum: I like their curriculum a lot. They split their time about 70/30 between UC-Davis and at Kaiser ED in South Sac. The patients at UC-Davis tend to be sicker, and the patients at South Sac are less sick- abd pain, etc. There is usually only 1 resident on at a time at Kaiser, so you work only with attendings and the attendings grab you if there is something cool. As a third year, you spend much more time with the sickest patients, and you are expected to know the board in the area you are working in. They do tons of ultrasound at South Sac- like the attendings do their own DVT studies. They do a fair amount at Davis too, they do have 4 machines.

They get tons and tons of trauma since they are the referring center for trauma in most of Northern California. The ED handles all airways. Anesthesia is not called. Surgery does come for all trauma team activations, and I didn't get a good handle on how they work together-maybe Dr. Will can elaborate. Overall the residents said everyone gets along fine with occasional conflicts.
One of the residents told me I would get more than my fill on my trauma month.

The off service rotations seemed very strong. They do their anesthesia rotation at Kaiser, so there are no other residents around, and all you do is intubate that month for a few hours in the morning. Other residents talked about how much they liked their ortho month, and someone was talking about how awesome their opthamology rotation was, with other residents nodding in agreement (I have not heard that at any other program!). The PD wants the off-service rotations to relate directly to EM, and not doing scut work for other programs.

They require a research project of publishable caliber, not a scholarly activity. They have a process set up where different faculty critique and analyze the project at different stages through your pgy2-3 yrs, and everyone has a research advisor.

Patient Pop: There is no county hospital in Sacramento, so this serves as one. Also they are admitting people who are super super sick and going to Davis for specific treatment. Overall the pop at Davis is sick, with high admission rates, lots of trauma (PD said 75% blunt, 25% penetrating). Kaiser is less sick, this is where you work on being efficient and seeing less sick pts.

Location: Sacramento, CA. I'm not from CA, and everyone was telling me how much Sacramento sucked, but I was pleasantly surprised. It is usually above 50 degrees all year long, affordable, has cool bars/restaurants, and is an hour and a half from SF, hour and a half from Tahoe. Residents do lots of outdoors stuff. Since I didn't grow up next to a beach, I would love to live somewhere like there, but I understand how people get spoiled.

Perks: Benefits are all covered for residents and partners. Like, 100% covered. One resident was telling us how he and his wife just had a baby and they didn't receive a single bill. I don't think you need to be married to cover a partner, but don't quote me on that.

Overall: I loved the feel of this program. Residents are cool and laid back, faculty are smart and approachable, PD goes to bat for you. You will be a good doc when you graduate, and can go to competitive places. (e.g. Grads have recently gone to SF, and San Diego) Research is strong also, with opportunities for those interested. This program will be high on my list.

Pretty right on review! I loved my month at UCD, and I can't stress how great the residents and faculty were. The residents were very cool and laid back, always trying to find ways for the students to shine in front of the faculty. This is a great university based program, but it serves as the area's county hospital. You will see a bunch, and a high volume of trauma....trust me on this one.

As for the trauma activations, there are 3 levels...911, 922, 933. 933 is run by the ED. 911 and 922 activates the trauma team. In the ED, the R3 in area 1 responds to trauma and manages airway...that's it. They do manage the patient while in the ED, but procedure wise, it's just airway. Trauma does the rest. There is usually an intern on trauma, doing whatever procedures need to be done. To be honest, there is so much trauma that runs through here that you will be exposed to it all.
 
On the horizon for the next week...BMC, King's County/Downstate, Drexel, UofMD. Georgetown has already been covered. Busy week, but I'm enjoying writing the reviews. It really has been helping me with starting to create that mental ROL.

Keep contributing people!
 
Look, didn't mean for it to be a big deal... Was merely pointing out that St. Louis isn't all that bad.

The real appeal of Wash U is the diverse mixture of the wealthy population (who come because BJH is considered top ten in the nation in health care) and the true inner-city population (because of the close proximity to some of the worst neighborhoods in the country).

This is true, and I'm not making a big deal of it. My girlfriend and I want to LOVE where we live and neither of us see ourselves happy living there compared to the other places I could end up. I gave her one place to veto, and this was it.
 
This is true, and I'm not making a big deal of it. My girlfriend and I want to LOVE where we live and neither of us see ourselves happy living there compared to the other places I could end up. I gave her one place to veto, and this was it.

Haha. Its funny how that works out. Most everyone knows that I thought very highly of Emory, and would have had a very tough time deciding between them and Wash U, except my wife used her veto power on Atlanta, and made it easy for me to rank Wash U #1.
 
The Newguy81 wrote:

UofChicago: A 3 year program with a strong academic reputation .–. which I think is a hard mix to find.



..... Really ?!? (and no, this isn't a dig at U of Chicago)
 
Any NW reviews out there?
 
How about an Emory review?
 
ProgrThere was a big "ER" party in October that many residents from other programs attended as well.


Overall: The most autonomy I've seen in any three year program. Huge volume, no competition with other area hospitals for trauma and sick patients. Residents come out super-prepared as they get to run an ENTIRE zone of the 110K ED as a PGY-3. The only downside is that it seems if you want to read a lot and focus on brainy stuff you have to be really focused and motivated to self-teach. Don't get me wrong, there is a lot of bedside teaching, but studying for the boards and didactic stuff might be a little lacking in the curriculum. I absolutely fell in love with this program, it will probably end up very near the top of my list if not number one.

QUOTE]

HMMMM, sounds like you rotated there in October . . .?
 
FYI U of Az gave a nice pay raise for next yr I think PGY1 will be making 42K or so.
 
Any SUNY Upstate reviews or Buffalo??
 
Anyone else find it a bit annoying when people who haven't bothered to contribute any of their own opinions ask for others to do reviews?

no
 
Yeah, I'm slightly annoyed by it too.
 
Top