PROs: I rotated there and loved it. You will love it to if you love county. 3 year program that used to be a 2-4 (faculty there say they still wish it was but they were losing quality applicants), and you can tell by the autonomy afforded to the residents early off. Not a place for people who need hand holding, but you will get guidance mostly from the senior residents but also from faculty who act more like consultants. Completely resident run. Busy but not too busy that you can't think county hospital with a lot of high acuity running through there ICU and resucitation areas and a lot of primary care running through the fast track, all 3 areas are run by residents. Great population to learn EM from. Patients are mostly indigent, primarily black and white. Nursing and ancillary services are good for a county. No drawing blood or putting in IVs and push only sick patients to radiology if you are worried about them (although students sometimes push people to x-ray to speed things up if they are not seeing patients). Front-loaded curriculum with interns worked VERY hard during first year even during ED months and significant drop off thereafter. PGY-3's work < 40 hrs/wk and most moonlight and earn a SIGNIFICANT addition to their salary that year. One of the best trauma systems I have seen in terms of relations with surgery. Trauma gets sent in to a special area adjacent to the main ED and the EM resident who is stationed in trauma works with the trauma team. Technically they switch off with surgery on who runs it day after day but there is so much trauma that usualy the trauma team gets busy in the OR and the EM resident who is on the resucitation shift gets to run much of the trauma on most days. EM is the strongest department in the hospital hands down. Consultants and other services don't come down to the ER unless asked and looking back on it I only saw one consultant in the ED the whole time and I think it was an interventional cardiologist guiding an EM resident through a procedure he was suppose to be doing but the EM resident wanted to try (and he did it). The leadership/administration (Godwin, Caro, Morrissey) are some of the coolest and funniest people I have ever met as well as being excellent clinicians and teachers. Conferences are very good and all have some form of hands on activity with the high tech simulators they have there. The senior residents are very good at what they do and run the ED w/o much help from the attendings.
Cons: The city of Jacksonville. The social scene is just bad. It's hard to find something to do on a Friday or Saturday night and you can forget about going out during the week. Also not much diversity. However, if you are not into that you should be fine. The city has everything else that a big city has (malls, theatres, food, etc). If this program was in a bigger, more active city it would have been at the top of my list. As far as the program: 1/2 shifts are fast track for the first year and like half of the second year with the other 1/2 being ICU (which is more like the real ED w/o the primary care and lacs/abcesses/std's/etc, its not really an ICU thats just what its called). Somewhere in the middle of second year they start letting you work the resucitation area (all unstable patients + trauma... either if EMS brings in someone unstable or if someone in the ICU or fast track becomes unstable they get wheeled into this area where the one and only resident who is staffing it will handle the resucitation) which is separate from the ICU and REALLY cool, but after your one dedicated month you only get like 3 shifts there per month for the remainder of your residency with the other shifts split 50/50 between fast track and ICU. It kind of sucks though when you are working the ICU part of the ED because you lose your patient if they become unstable and the resuc resident takes over. I think the residents pretty much master the fast track area pretty early in the second year though they still spend roughly 40% of their shifts in it. Trauma is plentiful but about 90% is blunt. They round like Internal Medicine (well maybe not that bad but it typicaly lasts for over an hour) on all the patients in the resuc area and ICU area every 8 hrs I think. They say its a strength of the program because its like you are seeing that many more patients without really seeing them but im not so sure all the residents really thought the same especially after a long and taxing shift. Teaching during these rounds is very dependent on the attending sometimes good sometimes not. Godwin is being promoted from PD to chair of something or other so he will still be pulling shifts and what not but I don't think he will be as involved as he was with the program. Although his replacement, Caro, is awesome as well.
Ummm thats all i can think of PM if you want any more info
