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I have heard mixed things about Jacobi...just wonder what you guys think.
thoughts on Jacobi
- Thread starter hello23
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hello23 said:
I rotated through Jacobi this summer...here's the scoop:
Yes, they are a 2-4 program but by getting that intern year out of the way they allow you to focus on Emergency Medicine for the rest of the three years. Unlike other programs their residents don't have to do Medicine on the floors, they are only required to attend rounds and not carry patients on other services such as ICU and CCU. Their thinking is that you do most of the necessary and evil scutwork during your intern year.
Great training too...I had my interview during the last grand rounds and they presented a case of a 32 yo cab driver who chased after a fare beater...was shot multiple times in the thigh and scrotum. On top of that to escape the shooter he jumped out of a two story building. These kinds of things happen on the regular at Jacobi...you see at least one crazy case a week.
That area of the Bronx is a great and very safe place to live!
The pay is really high for residency programs, the benefits including meal card are amazing!
They run traumas. I mean truly run traumas, they make the decisions on whether or not they should call trauma down.
Trauma complained that their residents weren't getting enouhg chest tubes so the ED ran a study and concluded that surgery residents got enough chest tubes on the other services.
The biggest plus!! A new building was just erected and will be fully functional by February. It is supposed to be state of the art.
The negatives: Not as academic as some other programs but they're trying to improve that. Not enough ancillary staff, so you will have to do some transporting, bloods, and IV's. But I think it's a part of training...who do the nurses go to after they're unsuccessful....US!!
hope this helps somewhat....
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I am an EM-2 (PGY-3) at the Jacobi/Montefiore combined emergency medicine
residency. It is a 2-4 program affiliated with Albert Einstein College of
Medicine. The two clinical sites provide a good mix of patient populations
and pathologies. Each site has over 100k visits/year. As one of the oldest
EM residencies in the country (over 25 years old) and as a separate
department within the College, we enjoy a lot of autonomy. Jacobi is the
quintessential "county" level one trauma center that receives every major
trauma in the northern Bronx and lower Westchester. The ED is entirely
resident run. As a PGY-2 (EM-1) the residents are responsible for the
minute-to-minute aspects of patient care. The PGY-2 (EM-2) acts as the
"chief" of either the medical or the surgical side of the department and is
responsible for triage, patient flow, and assigning the more complex cases
to the lower level residents. The PGY-3 (EM-3) functions as the attending,
making all dispo decisions with the help of the attending. Cases are
presented to either the attending or the PGY-4 depending on the day and the
side of the department, It is this "graduated" responsibility that is unique
to our program and makes the transition to attending upon graduation from
the program a very smooth one.
Traumas are run entirely by the EM residents. The in-house trauma team is
called by us only after the patients are stabilized or if they are going
right to the OR. We have lots of experiences putting in chest tubes, lines,
etc. The airways are also entirely run by us as there are no anesthesiology
residents in-house. We have four ultrasound machines owned by our department
and an ultrasound fellowship program that will be starting this spring. We
have our own CT scanner and four radiology rooms. Montefiore is the academic
center of the medical school and is a major referral center. There is an
equal mix of private versus service cases. The ED is run like a more
traditional department with all cases presented directly to the attending no
matter what level of training. The medicine experience tends to be more
complex here with transplant patients, referral patients, and more "zebras"
than are seen at Jacobi.
As a 2-4 program we have very few off service rotations. We are not "farmed"
out to the other services as cheap labor. You'll get enough experience in a
well-rounded preliminary or transitional year so that repeating those
rotations as an upper-level resident would not be productive. Our
relationships with the other services are great and as a well-established
independent department, many of the "battles" have been fought and won by
those who came before us. We have full admitting privileges to every service
in the hospital. As for scholarly pursuits, there are plenty of attendings
who are involved in research. There is also a research fellow at the Jacobi
site. Our chairman, Dr. Gallagher, is an editor of the Annals, and is very
supportive of the residents.
Jacobi is also home to one of the busiest multi-person hyperbaric chambers
in the country and the snakebite referral center for the entire Northeast.
Graduates from the program (there are over two hundred out there) are
everywhere in academia and in the community. Once a year we have an alumni
event that is great for networking. The attendings and departmental
leadership at both sites are excellent and their main job is teaching the
residents. We have a very active attending-resident advisor program.
Half of the residents live in the Bronx (Montefiore offers very inexpensive
housing) and about half live in Manhattan. Both sites are 20 minutes away
from the upper east side of Manhattan (by car or subway). Half of the
clinical experience is done during the first year, with the EM-1 residents
working 10 twelve-hour shifts in 14 days at both sites. As an EM-2 the
schedule decreases to 8-9 shifts in 14 days (Jacobi shifts decrease to
8-hour shifts) and the EM-3's work 7-8 shifts in 14 days.
Upon graduation we definitely can handle any type of emergency that rolls
through the doors because we have seen and done it all. Jacobi has built a
new ED that will be opening in the spring of 2005. Residents have had a lot
of input into the design and flow of the new department and we are all eager
for it to open.
-Jason
residency. It is a 2-4 program affiliated with Albert Einstein College of
Medicine. The two clinical sites provide a good mix of patient populations
and pathologies. Each site has over 100k visits/year. As one of the oldest
EM residencies in the country (over 25 years old) and as a separate
department within the College, we enjoy a lot of autonomy. Jacobi is the
quintessential "county" level one trauma center that receives every major
trauma in the northern Bronx and lower Westchester. The ED is entirely
resident run. As a PGY-2 (EM-1) the residents are responsible for the
minute-to-minute aspects of patient care. The PGY-2 (EM-2) acts as the
"chief" of either the medical or the surgical side of the department and is
responsible for triage, patient flow, and assigning the more complex cases
to the lower level residents. The PGY-3 (EM-3) functions as the attending,
making all dispo decisions with the help of the attending. Cases are
presented to either the attending or the PGY-4 depending on the day and the
side of the department, It is this "graduated" responsibility that is unique
to our program and makes the transition to attending upon graduation from
the program a very smooth one.
Traumas are run entirely by the EM residents. The in-house trauma team is
called by us only after the patients are stabilized or if they are going
right to the OR. We have lots of experiences putting in chest tubes, lines,
etc. The airways are also entirely run by us as there are no anesthesiology
residents in-house. We have four ultrasound machines owned by our department
and an ultrasound fellowship program that will be starting this spring. We
have our own CT scanner and four radiology rooms. Montefiore is the academic
center of the medical school and is a major referral center. There is an
equal mix of private versus service cases. The ED is run like a more
traditional department with all cases presented directly to the attending no
matter what level of training. The medicine experience tends to be more
complex here with transplant patients, referral patients, and more "zebras"
than are seen at Jacobi.
As a 2-4 program we have very few off service rotations. We are not "farmed"
out to the other services as cheap labor. You'll get enough experience in a
well-rounded preliminary or transitional year so that repeating those
rotations as an upper-level resident would not be productive. Our
relationships with the other services are great and as a well-established
independent department, many of the "battles" have been fought and won by
those who came before us. We have full admitting privileges to every service
in the hospital. As for scholarly pursuits, there are plenty of attendings
who are involved in research. There is also a research fellow at the Jacobi
site. Our chairman, Dr. Gallagher, is an editor of the Annals, and is very
supportive of the residents.
Jacobi is also home to one of the busiest multi-person hyperbaric chambers
in the country and the snakebite referral center for the entire Northeast.
Graduates from the program (there are over two hundred out there) are
everywhere in academia and in the community. Once a year we have an alumni
event that is great for networking. The attendings and departmental
leadership at both sites are excellent and their main job is teaching the
residents. We have a very active attending-resident advisor program.
Half of the residents live in the Bronx (Montefiore offers very inexpensive
housing) and about half live in Manhattan. Both sites are 20 minutes away
from the upper east side of Manhattan (by car or subway). Half of the
clinical experience is done during the first year, with the EM-1 residents
working 10 twelve-hour shifts in 14 days at both sites. As an EM-2 the
schedule decreases to 8-9 shifts in 14 days (Jacobi shifts decrease to
8-hour shifts) and the EM-3's work 7-8 shifts in 14 days.
Upon graduation we definitely can handle any type of emergency that rolls
through the doors because we have seen and done it all. Jacobi has built a
new ED that will be opening in the spring of 2005. Residents have had a lot
of input into the design and flow of the new department and we are all eager
for it to open.
-Jason
- Joined
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Rotated there, interviewed there. Probably one of the better county-style programs in the country, IMHO. The residents truly run the ED. Worked with a few Jacobi grads and they all have a very no-nonsense approach to EM.
Tough place, rough schedule, very poor ancillary staff at Jacobi especially, having to do a year of medicine/surgery and not too much community experience would be the downsides. Supposedly have a new ED soon, which should be nice.
Tough place, rough schedule, very poor ancillary staff at Jacobi especially, having to do a year of medicine/surgery and not too much community experience would be the downsides. Supposedly have a new ED soon, which should be nice.
