Here is another review of UAB that I recently placed on scutwork.com (it is currently being reviewed for posting). It reiterates a lot of the points made by my fellow residents. I'd be happy to entertain any questions also. PM me.
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Visit our website
here.
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The University of Alabama at Birmingham's emergency medicine residency program has been around since 2000. It has undergone many changes since its inception, but it is now starting to settle in as a premiere southern location to train in emergency medicine. We have just been APPROVED to convert from a PGY2-4 program to a PGY1-3 program. We will be interviewing our first class of 8 interns this November through ERAS.
Residents work an average of 55 hours a week, once you include our 4 weekly hours of lecture. Shifts are 8 hours M-F, 12 hours on weekends. Because we work weekend 12s, every resident gets 2 weekends off / month. Also, the PGY3s and 4s typically will get one 3-day weekend off / month. In a typical ED month, 28-day block:
PGY2s work 19 shifts:
- 16 UED eights
- 3 UED twelves
PGY3s work 19 (easier) shifts:
- 11 UED eights
- 3 UED twelves
- 2 EMS ride-along eights
- 3 Peds ED eights
PGY4s work 17 shifts:
- 11 eights
- 3 twelves
- 3 Peds ED eights
*After the format change the number of shifts for interns will be roughly the same as those listed here for PGY2s.
A typical day begins in the "rounds room," where all oncoming and offgoing residents meet to discuss an interesting patient or two. The offgoing senior resident and attending usually give a "pearl," then everyone breaks to their respective work assignments. The emergency department at UAB is divided into varying pods according to patient acuity; each pod is between 9-12 beds. There are separate pods for urgent care (covered by one attending - we never have to work here) and trauma (covered by trauma team: 2 EM residents on team / month). There is usually one EM resident / pod, with rotating residents helping out in the lower level's pod as well. PGY2s starting out are expected to carry at least half a pod, slowly graduating to a full pod by themselves as a mid-year PGY-2. Attendings will see patients on their own to facilitate ED flow.
Workload includes taking checkout from the offgoing resident ASAP after rounds to get them home. Each patient encounter is dictated by the resident. PGY-3s begin to take checkout from medical students and rotating interns. PGY-3s and 4s carry an airway pager that receives trauma alerts (shock trauma). They respond to the trauma bay to cover the airway. Every resident carries a wireless phone for consult calls.
There is little to no scutwork here. All IVs started by nurses, techs to transport, RTs manage vents. After having worked at The Med in Memphis, Grady in Atlanta, and Erlanger Hospital in Chattanooga - I can confidently say that the ancillary staff at UAB is second to none. This ED has the feel of a community hospital, with the patient mix of both a well respected tertiary care transplant and trauma center as well as your typical county indigent population.
Off service rotations for the PGY2s include: Anesthesia, OB/GYN, Trauma, PedsED, Ortho, MICU, and Cardiology. PGY3s have Toxicology, Ophthalmology/NICU, PICU, community ED rotation in Montgomery, and an Elective. PGY4s have the same Montgomery rotation, a Research/Administration month, a senior Trauma rotation, and 2 Elective months. UAB's other residencies are nationally known and well respected - our off service education is fantastic.
Teaching
We have an ever growing core faculty at UAB. Over the past few years we have added an average of 3 faculty / year. The eldest faculty is a well seasoned IM trained doc who was practicing EM before it was its own specialty. We are getting some young energetic attendings just out of residency several from Charity, Emory, and UVA. All faculty are interested in resident education, teaching on the fly at the bedside. There are a growing number of faculty who will sit down in the middle of a busy shift to give you a mini-lecture on a pertinent EM topic. Didactic education occurs during our weekly lecture series, on Wednesday mornings. Lasting 4 hours, this lecture time is 100% protected. Lectures are very high quality, and typically interactive. Of course, core EM topics are covered in detail with a slant toward current evidenced based medicine. Literature-based lectures occur monthly, including a two-hour journal club hosted by a different attending each month. We frequently have collaborative lectures with the MICU, trauma, pediatrics, radiology, neurology, and cardiology. Each month we cover a topic in Tintinalli and go over board questions. We also do oral review cases for the upper level residents in front of an audience (to simulate the stress of oral boards). Just recently UAB has converted and old MICU into a simulation lab, with $100k patient simulators on which residents can perform procedures (intubate, central lines, pericardiocentesis, cricothyrotomy, etc) and run codes (EKGs / chest compressions etc). Our goal is for our residents to run simulation codes once every 2 months.
Atmosphere
Residents have a close sense of camaraderie. After meeting for weekly lectures we all have lunch together (typically sponsored). Monthly planned outings at local restaurants and pubs and monthly nighttime journal clubs bring us together. Many attending will come to these events as well, some will ask you out for a beer after your evening shift. Last year we had our first-ever resident retreat. Everyone was given 36 hours free from all clinical duties, and we all spent the day at a lakehouse. This really brought a sense of cohesiveness to the residents. We are in the mist of planning this years retreat, which the faculty wholeheartedly support. About half the residency is married, some with children. I have developed lifelong friendships with a few of my fellow residents. Our residents come from all around the states including many from the southeast, California, Michigan, and West Virginia to name a few. While UAB does accept IMG applications, we currently only have US graduated residents. UABs physical plant is fantastic. A new state of the art emergency department was built a few years ago, and officially opened in November 2004. The setup for each pod is a central desk: one side has 4 computers for the nurses and desk clerks, and one side has 4 computers for the physicians. There are consult nooks with computers for admitting residents. The central desk is surrounded by 9-12 rooms. There is a psych room, ortho room with a C-arm, a medical resuscitation bay, an OB delivery room with warmer, and 6 trauma bays. Many people think of the old south when they think of Birmingham, but what they do not realize is that it is really quite progressive. There is affordable housing on a residents salary, some great nightlife in 5-Points, and some incredible eateries. There are great family neighborhoods in Hoover and Homewood, with several neighborhoods for young artsy intellectuals in the Highlands area. Atlanta is just 2 hours to the east, Chattanooga 2 hours to the north, and San Destin beach Florida is a short 4 hour hop away. With 2 weekends off per month and many light off-service rotations, many residents have time to do some moonlighting. There are several single and double covered EDs within easy driving distance of Birmingham where residents can moonlight to make some extra money easily doubling their monthly income. Also at UAB is a unique in-house moonlighting opportunity called critical care transport. The service includes 3 EMS trucks and 2 fixed wing jets that serve to transport critically ill patients between hospitals. Residents can moonlight on this service, providing critical procedures and medical care to one patient per trip.
Conclusion
Past residents who have graduated have taken faculty positions, joined lucrative community EM practices across the US, and one recently completed a prestigious EM cardiology fellowship at UVA. There is ample opportunity to do research and publish papers, and also to write review articles or book chapters. For those interested in a fellowship after residency, UAB currently offers a critical care fellowship and a research fellowship. Overall, I feel my EM education at UAB has struck the perfect balance between book smarts and clinical relevance. After seeing many southern EM residencies including CMC and Emory, UAB was my #1 choice in the match. If I had to do it all over again, I would, without a doubt, select UAB. This is a program that really is going places. One major advantage to UAB is that it is young enough that residents still have a major say in the shape of things to come, and old enough that all the major kinks have been ironed out. I would certainly welcome any questions about what we have to offer at UAB.
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b
. Looking forward to seeing it for myself.
