Vandy, VCU, MD...

[jsmith123]

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Can anyone give me some insight on these three programs in particular? I'm interested in Trauma/Critical Care (planning on doing a fellowship after residency) and I've been looking hard at these three programs. They all seem good. Can anyone give me some more info on them? Such as:

1) What is the trauma exposure like? Do EM residents play an active role or is it dominated more by surgery? Do EM residents get a lot of exposure to Trauma throughout the year or only when on the Trauma rotations? Do you get a lot of trauma?

2) Sick patients? How sick? How long do they stay in the ED? Do EM residents get a lot of experience managing critically ill patients or do they whisked away to the unit (or does the ICU team take them from you even though they are still in the ED?) I want to be involved in taking care of these folks.

3) Faculty involvement in Trauma/CCM? How involved are the faculty in these areas? Are they advocates for EM involvement in these areas or are they more content to let the other services have them?

4) Research? What kind of research opportunity is there?

Any other info that you think might be helpful (or other programs that I should look into) would be apprecitated.

Thanks!

 

[mikecwru]

Can anyone give me some insight on these three programs in particular? I'm interested in Trauma/Critical Care (planning on doing a fellowship after residency) and I've been looking hard at these three programs. They all seem good. Can anyone give me some more info on them? Such as:

1) What is the trauma exposure like? Do EM residents play an active role or is it dominated more by surgery? Do EM residents get a lot of exposure to Trauma throughout the year or only when on the Trauma rotations? Do you get a lot of trauma?

2) Sick patients? How sick? How long do they stay in the ED? Do EM residents get a lot of experience managing critically ill patients or do they whisked away to the unit (or does the ICU team take them from you even though they are still in the ED?) I want to be involved in taking care of these folks.

3) Faculty involvement in Trauma/CCM? How involved are the faculty in these areas? Are they advocates for EM involvement in these areas or are they more content to let the other services have them?

4) Research? What kind of research opportunity is there?

Any other info that you think might be helpful (or other programs that I should look into) would be apprecitated.

Thanks!

You should tread carefully if your heart is set on critical care via EM. There are people on this forum with more substantial opinions than me, but from what I've read, becoming board certified in the US in CC via EM is not in the forseeable future.

I interviewed at Vandy and MD. Both have strong surgery, particularly trauma at MD. When you have a strong "outside" department, this can be both a blessing (education from experts) and a curse (turf wars) with regards to EM. I particularly did not care for how MD fragmented much of their experience, especially in trauma.

I'm not trying to discourage you, but think about what you want, if you truly want critical care, you may choose to go another route. Most EM types don't prefer having ICU patients down in the ED for days on end.

mike

 

[NinerNiner999]

Come check out Hopkins too - we do two months of Trauma at MD and believe me, between the three ED's we train at, there is PLENTY of emergency medicine to learn. Besides - it's great to learn from faculty who are co-authors of Tintanalli (Dr. Gabor Kelen), leaders in EM and International EM research, and off-service leaders known internationally in their fields. Yeah - I just finished a 35 hour call shift and am getting ready to start another one tomorrow, but the work and exposure are second to none (read: I took house call for plastics, burns, and pediatric surgery my first day as an intern - 4 floors, 2 buildings, 73 pages and 47 patients - talk about exposure!). Ahhh, I lika do da cha cha...

 

[KGUNNER1]

Can anyone give me some insight on these three programs in particular? I'm interested in Trauma/Critical Care (planning on doing a fellowship after residency) and I've been looking hard at these three programs. They all seem good. Can anyone give me some more info on them? Such as:

1) What is the trauma exposure like? Do EM residents play an active role or is it dominated more by surgery? Do EM residents get a lot of exposure to Trauma throughout the year or only when on the Trauma rotations? Do you get a lot of trauma?

2) Sick patients? How sick? How long do they stay in the ED? Do EM residents get a lot of experience managing critically ill patients or do they whisked away to the unit (or does the ICU team take them from you even though they are still in the ED?) I want to be involved in taking care of these folks.

3) Faculty involvement in Trauma/CCM? How involved are the faculty in these areas? Are they advocates for EM involvement in these areas or are they more content to let the other services have them?

4) Research? What kind of research opportunity is there?

Any other info that you think might be helpful (or other programs that I should look into) would be apprecitated.

Thanks!

Don't let Mike get you down. 🙂 US board certification will eventually come. Until then, you can take the European boards (after you do a 2 yr fellowship in critical care) and you'll have no problems practicing in the real world.

For the ER doc, a critical care fellowship is no different than doing a tox or EMS fellowship, you'll bring something to your group that most others don't have. Whether we like it or not, the ER will be seeing sicker patients for longer times. We HAVE to be able to take care of them just as good in the initial 6-12 hours as our critical care collegues in the units. By the time you are practicing, there will be no hiding. Protocols like Early Goal Directed Therapy for Severe Sepsis and Septic Shock (Rivers NEJM, Nov 2001) will be standard of care. You will have to know this just like stroke, acute coronary syndrome, and trauma.

I can't speak for the others, VCU has 3 EM/CCM attendings and a 4th who is the research director and has done extensive research in resuscitation. Check out the website for the shock group www.vcures.com.

For your residency, you can't go wrong with any of the programs listed in this post. I always tell residents you have to be a great ER doc/resident first before you can be a good critical care fellow.

I recommend, where ever you train, to leave to do your fellowship. You need to see how others handle critical care, since you'll be comfortable in 3 years of how the "local" politics are done. I trained a Pitt and it was a great program and extremely open to ER docs (www.ccm.upmc.edu). Shock trauma is also open to ER docs and I have several friends who loved the training there.

Follow your heart, if you really like critical care, do a 2 year fellowship. I currently practice both and do resuscitation research and feel like I have the best job in the world.

Good luck, and like always, if anybody has other questions, feel free to email me off list.

Kyle