Where did you have a *great* student EM rotation?

[mega_colon]

Per my PD, some programs are well known for protecting their own students with stellar SLOEs and then writing mediocre SLOEs for even great visiting students.

I'm just looking to avoid stepping on any SLOE grenades by accidentally rotating at these places.

---

Members don't see this ad.

 

[quickfeet]

WAS wondering how U Kentucky or U Louisville away rotations are. Also U Texas Houston.

 

[Apollyon]

Per my PD, some programs are well known for protecting their own students with stellar SLOEs and then writing mediocre SLOEs for even great visiting students.

I'm just looking to avoid stepping on any SLOE grenades by accidentally rotating at these places.

Amongst other PDs. That's why it would be GREAT if someone would 'name names'.

 

[theMan2012]

Denver is a name that comes to mind after hearing from others that have rotated there. They are also a strong program and thus get many strong applicants so the applicant pool they are trying to stratify may also be stronger thus leading to many strong applicants ending up with mediocre SLOEs. Irrespective of that, there is word that they grade harshly for whatever that is worth.

 

[HoosierdaddyO]

NYU had one of the best rotations that I've personally been part of

 

[Cinclus]

Denver is a name that comes to mind after hearing from others that have rotated there. They are also a strong program and thus get many strong applicants so the applicant pool they are trying to stratify may also be stronger thus leading to many strong applicants ending up with mediocre SLOEs. Irrespective of that, there is word that they grade harshly for whatever that is worth.

I have heard that even the SLOEs written for their own students can be a bit harsh.

 

[Cinematographer]

Probably not a great idea to air that out on SDN. A couple of my upperclassmen told me about places to avoid (due to negative SLOEs) and I followed their advice.

Just fyi, the reviews I have posted were all submitted anonymously through Google Forms, so I don't see how making this information available isn't a "great idea."

The anonymous form is still open for anyone with time to review their away rotations.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: University of Mississippi Medical Center
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: Great didactics, frequent sim-lab with skills practice and chances to run scenarios. Lots of attending exposure and feedback, friendly and knowledgeable residents. Lots of sick patients. I definitely recommend.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Cook County
Rotation: EM Clerkship
SLOE Provided: Yes

Comments: Schedule: 14 to 15 8 hour shifts. The coordinator is nice and willing to switch schedules around during orientation, so if you have a major event it is possible to switch.

Didactics: Every monday there is an hour of lecture at noon. Topics include eye emergencies, sim lab, airway lab, ekg's. Resident conference is every Wednesday, which are about 3 hours long.

Grading: P/HP/H system. Grading is based on Rush's rubric. Need 83 or above for Honors, 79 and above for High pass, and anything under 79 is a pass. Performance is evaluated by a Senior Resident or Attending at end of each shift via online survey. Some residents/attendings are harsher graders than others, so I feel at times it can be luck of the draw. 2/3 of your grade is based on shifts while the other 1/3 is based on a presentation on a topic of your choice.

Faculty/Residents: As stated earlier, you present to either a senior resident or attending. Most residents were really nice and laid back. Very eager to help and teach. Attendings were great for the most part, though some were more difficult to work with.

Procedures: You will get to do a lot of suturing and I&D's. Intubations, LP's, lines, and splinting were harder to come by.

Overall: Great rotation with a lot of responsibility and opportunity to see sick patients. You own your patients. Cons were difficulty getting procedures other than suturing and I&D's. Also, there was little trauma exposure as trauma is its own separate ED.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: University of Nevada, Las Vegas
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: I didn't really click here. It seemed like most of the faculty had no desire to teach med students or residents (although some were great). Didactics were mostly resident run and fairly mediocre. No sim. Besides most the residents being really cool and a few good faculty it was generally a disappointing rotation and I plan on ranking them at the bottom of my list.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Baylor College of Medicine
Rotation: EM Clerkship
SLOE Provided: Yes

Comments: Here is my disclaimer at Baylor because this review will likely come off as very negative - the recently lost a lot of faculty between June and September and they got a brand new program director so everything was a bit of a mess while I was there. It was all very disorganized.

Ok, moving on. I was very lost about this rotation from the get go. After getting accepted through VSAS I heard nothing until the week before the rotation and that communication was just "fill out these papers immediately so we can get started on computer access through Harris Health". There was never an email about where/when was orientation and I could never get anyone to respond to emails/messages so I just showed up on the first Monday and luckily it was the right time/place. The first day is pretty much spent getting badges and doing paperwork for Harris Health. They also charge you an extra $20 for I'm not sure what after you already paid the program fee - solidly annoying. I magically met up with the other away students during this process and we were all scheduled for shifts that day - makes no sense. We then found out we had EM orientation at 3pm that day. Everything on this rotation was "fly by the seat of your pants". They use EPIC but you have to redo Harris Health epic training online and then go take a test - a physical EPIC test. And until you do this you don't have EMR access but the testing center across town is only open 2 days a week. You do get access to the scrub machine - very convenient. But parking is not included - and to park in the garage is $12 a day if you are there longer than 4 hours.

You will work 14-18 8 hour or 12 hour shifts (Fr/Sat/Sun are 12 hr shifts) and be prepared for your schedule to make very little sense. You will work in critical care (trauma), Core A and B (medical dz), and Core C/E (pedi and minor care) - you will have a variety of these shifts; I only had 1 critical care shift while many of the other rotators had >5, it is all just completely variable. I was flipped between nights and days multiple times in the same week. You have sim sessions every Tuesday 1p-3p and resident didactics are 8a-12p every Wednesday. And you are expected to go to all of them regardless of your schedule (even if you worked a night shift previously) - no one cares. Thankfully the Baylor student lounge has comfy couches.

You carry around a booklet all month to get evals from faculty at every shift and log the patients you saw. You will be generally paired with a 3rd year resident for the month - you will work with the same upper level on his/her shifts with rotating interns. You will have some select shifts that will not be with your resident but will be with program higher-up faculty, like the PD and the APD. The upper-level resident will make or break your entire experience. In my case, she totally killed my whole rotation. But most of the upper level residents are amazing and love to teach and involve you in procedures, unfortunately mine did not. There will also be anywhere from 0-4 3rd yr medical students and sometimes another 4th year on your shift - scheduling is a struggle. Some of the faculty here are amazing and will really turn this program around - Dr Pillow, the new PD treated me like an intern and I got to do my own orders; both Dr Wu's love to teach; but I would say about 50% of the faculty seem unhappy and very burned out. Just not the most positive experience I have ever had. The SLOE is written by one of the clerkship directors with your shift evals in hand - I have never met the woman writing my SLOE so I find that a little unsettling.

I had very high hopes for this rotation after coming off of 2 other amazing EM rotations and I was very unhappy during this month. I found the faculty to be overall negative and not interested in teaching and my resident told me point blank of the first day that she doesn't like having 4th years because she hates mentoring and hates teaching. I think I just got a bad draw, but I think this program will make an amazing turn around in the next few years. The new PD is amazing, personable, and very interested in teaching. I would personally give him a few years to fix up this program before encouraging anyone to rotate there.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: UT Austin
Rotation: EM Clerkship
SLOE Provided: Yes

Comments: I would not recommend rotating here if you can avoid it. They are very slow to release their SLOEs and do not have a good method to gather attending feedback. A little background how your shifts are set up here: You have 9-11 shifts in the low acuity area and 3 shifts in the high acuity area, as a result, procedure experience is very light. Furthermore, the attendings are switching back and forth between the 2 areas, and their shifts do not overlap completely with yours. As a result, I found myself presenting to 2-4 attendings per shift. I consistently received great feedback from the attendings I worked with. This program lacks a good mechanism to gather such feedback based upon the sparse comments on my grading form and the multiple month delay to obtain my SLOE and grades. Many of the EM faculty that you end up working with are community EM physicians and not part of their core faculty, so it is unclear if any weight is given to their comments (or if their comments are included in your evaluation at all). As far as I could ascertain, a generic e-mail is sent to all of the faculty a month after you rotate gathering feedback.

I really enjoyed working with many of their faculty, but there seems to be a disconnect between the program director and clerkship director and these faculty. This is a young program in a growing population center that could definitely benefit from stronger leadership. It isn't a terrible learning experience here, but the lack of grading transparency and delay in getting a SLOE in a reasonable manner probably did not help my application. Additionally, the experience was rather limited since most of your time is spent working in a low acuity area.

_________________________

I guess folks are on a break from interviews/rotations this week given the surge of reviews I've received today alone. Glad to see that now we have both positive and the (much requested) negative reviews.

Thanks to everyone who has participated. To those who haven't: the anonymous Google Form is still open (and will remain that way indefinitely).

Edit: my own comments are now posted at the bottom of the review for clarity.

 

[StephBee]

I guess folks are on a break from interviews/rotations this week given the surge of reviews I've received today alone. Glad to see that now we have both positive and the (much requested) negative reviews.

Thanks to everyone who has participated. To that haven't: the anonymous Google Form is still open (and will remain that way indefinitely).

Now, back to business.
_________________________
Posted anonymously via Google Forms

Program: UT Austin
Rotation: EM Clerkship
SLOE Provided: Yes

Comments: I would not recommend rotating here if you can avoid it. They are very slow to release their SLOEs and do not have a good method to gather attending feedback. A little background how your shifts are set up here: You have 9-11 shifts in the low acuity area and 3 shifts in the high acuity area, as a result, procedure experience is very light. Furthermore, the attendings are switching back and forth between the 2 areas, and their shifts do not overlap completely with yours. As a result, I found myself presenting to 2-4 attendings per shift. I consistently received great feedback from the attendings I worked with. This program lacks a good mechanism to gather such feedback based upon the sparse comments on my grading form and the multiple month delay to obtain my SLOE and grades. Many of the EM faculty that you end up working with are community EM physicians and not part of their core faculty, so it is unclear if any weight is given to their comments (or if their comments are included in your evaluation at all). As far as I could ascertain, a generic e-mail is sent to all of the faculty a month after you rotate gathering feedback.

I really enjoyed working with many of their faculty, but there seems to be a disconnect between the program director and clerkship director and these faculty. This is a young program in a growing population center that could definitely benefit from stronger leadership. It isn't a terrible learning experience here, but the lack of grading transparency and delay in getting a SLOE in a reasonable manner probably did not help my application. Additionally, the experience was rather limited since most of your time is spent working in a low acuity area.

Just FYI: there's no program name for this post !

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Cook County
Rotation: EM Clerkship
SLOE Provided: Yes

Comments: I rotated at 4 different EM programs and my away at Cook was by far the best rotation overall. I believe I worked 12-14 eight hour shifts in the emergency department and was given significant autonomy. What made this rotation great is that its designed very well from a student perspective. For example, rotation evaluations are emailed to the the senior resident or attending you worked for following every shift rather than students having to carry around an eval to get signed. These electronic evals were then sent to you with feedback on what you did well or what you could improve upon. These remarks will then get put into your SLOE which I feel really strengthens the letter. This is not the type of program that hands out honors to every student, they make that clear up front. I think this means that a HP or Honors from Cook carries much more weight than a generic SLOE from a program that gives out all honors. That being said I don't think its hard to do well.

Students were also able to chart the patients HPI and place orders for labs/imaging without co-sign. Medications could also be sent to residents for approval. I think this is the exception rather than the rule when it comes to many clerkship rotations and really provides you fantastic autonomy. I found the attendings to be very knowledgable and the senior residents to really enjoy teaching. There is great US exposure with Dr. Cosby and Dr. Bailitz. There was also designated SIM time and resident lectures every week that accompanied the clinical training. There is a mandatory 5 minute case presentation at the end of the month which is very straightforward. No post test if you are from a school other than Rush. Grading is based on the resident/attending feedback and the case presentation. The only downside I can see is that there is no rotating in the trauma bay since its completely separate from ED which can make procedures harder to come by but that's what residency is for. Overall I'm extremely happy with my rotation at Cook and my time in Chicago!

 

[Cinematographer]

Just FYI: there's no program name for this post !

Am I hallucinating or does it not say UT Austin?

 

[alpinism]

Ouch.

Nice to see some honest evals though.

I've heard the same thing about UNLV from multiple people who rotated/interviewed.

Its a shame because the residents I've met seemed really fun.

 

[StephBee]

Am I hallucinating or does it not say UT Austin?

So weird. It doesn't show up on my screen but when I select it, it does.
See!

Ignore me. Probably an app glitch

 

[Cinclus]

Am I hallucinating or does it not say UT Austin?

I can see it.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Maine Medical Center
Rotation: EM Clerkship
SLOE Provided: Yes

Comments: Applied through VSAS. I had a really positive experience. The faculty and residents were enthusiastic and happy to teach. During my month there was a dedicated PGY3 "teaching resident" who we would present to on weekday afternoons; otherwise students presented to attendings. I saw slightly fewer total patients (maybe 0.7-1.0 per hour depending on the shift) than on my other EM rotation, but felt like I had more responsibility here (students expected to call most consults and admissions, practice putting in orders, etc.). There were also plenty of traumas and medical resuscitations, which we were encouraged to go observe and sometimes help out with. I got to do plenty of suturing, I&D's, some splinting and a reduction. Several other students did LP's. Students worked about fourteen 7-hour shifts, which would usually end up being 8-8.5 hours after tying up loose ends. We got to create our own schedules at the start of the month, which was awesome. Just had to include X number of nights, weekends, etc. Conferences and Sim sessions were fun; no complaints. Optional EMS/helicopter ride-along. Required to give a short presentation at the end of the month, topic of your choice. Housing was provided for free (!) directly across the street from the ED.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Palmetto Health
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: This is a program that's regionally-known and loved on SDN. I applied as a student from outside their region because I'd read great things.

The Good: The program is very laid-back and everyone is very nice (to your face). It has a family feel to it, the most relaxed of all of my audition rotations. The shift schedule was more than decent (I think 14-15 shifts that were 8's and 10's although I don't remember exactly). I did not feel overloaded and I was able to study for and take Step 2 during the month. Students get a meal break during every shift which was awesome. Didactics were solid. The student ultrasound training was excellent, much better than my previous two sub-I's and I thought that was great. The program director (Dr. Cook) is supposed to be amazing but I never worked with him.

The Bad: I didn't really fit in here. The program as a whole is VERY Southern, and even though I'm from several states away, I still felt out-of-place. Most of the residents and faculty are from South Carolina or Georgia, and the culture is just different.

Students have read-only EMR access, and you aren't able to look up imaging or old records. At my prior sub-I's I could do all of that, enter orders that my resident would change or approve, and write my own notes so I felt pretty useless because I couldn't do any of that at Palmetto. Feedback for rotating students here is just awful. At my prior sub-I's I received written feedback after EVERY shift, so you knew exactly where you stood, and those comments would go directly into your SLOE. There is no written feedback at Palmetto, and there were no mechanisms for evaluating your performance during the rotation. I asked the resident I worked with the most (~50% of my rotation) to sit down with me and go over my performance and it kept getting put off because they were too busy...and it never happened. Students are told to work with and present to senior residents but are evaluated by the attendings, who I talked to for maybe 10% of each shift, this is ridiculous. You never knew what they were going to write about you.

We had some limited SIM experience practicing airway management, and one day of simulations that were student-run where we took turns being the "team leader" of the other students. Our schedule said "SIM Day" which usually meant "watch the residents run through SIM cases". It wasn't explicitly stated, but it was obvious that the faculty were evaluating us when we were the team leader. It didn't bother me but I thought it was sort-of disingenuous.

We were given full access to HIPPO:EM during the month. We were told to watch about eight hours of specific videos and that our end-of-course examination would be over that material. It wasn't. Not even close. It was painfully obvious that the examination was over material from a book like First Aid for the Emergency Medicine Clerkship. This caused my end-of-course grade to drop somewhat.

This was my last sub-I after honoring the others, and I ended up getting unfairly skewered on my SLOE here, which killed my number of interviews. On top of that, they gave me a good course grade and an early invitation to interview after trashing me on my SLOE. The comments were completely out of left field compared to my previous sub-I's. On top of that, I never worked with the attending that wrote my SLOE. My SLOE from Palmetto was so out-of-place that I had multiple interviewers ask me about it because it just doesn't fit with my others SLOEs and the rest of my application. I had two interviewers tell me they were going to ignore it as an outlier because it just doesn't make sense.

__________________
Cinematographer's comments: It's kind of interesting to see how some well-respected programs don't necessarily have the most student-friendly rotations. Personally, the lack of written feedback is a big negative. I do hope changes are made based on reviews like this.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: University of Massachusetts
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: I loved this externship. Busy ER. Residents were eager to teach. 95% of the attendings were thrilled you were there and took time to give you some one-on-one teaching. 15 shifts +1 EMS shift. Got to do a central line, an intubation, tons of lac repairs. Awesome didactics with some dedicated medical student lectures and medical student labs. ER is well respected within the hospital.

 

[mega_colon]

These reviews are absolute gold. As a 3rd year starting to look at programs to rotate at its super helpful to have these on how some of these sub i's are run. Please keep them coming!

 

[Got Em]

Posted anonymously via Google Forms

Program: Mercy St. Vincent, Toledo, OH
Rotation: EM Clerkship
SLOE Provided: Yes

Comments: 3 year program, 14 residents per year.

12 shifts, 8 hours a each.

Simlab every-week, one day of EMS, possible Helicopter EMS if you can drive to the airbase.

You only work 12 8s during a whole month? That sounds like an insanely light schedule...

 

[Cinematographer]

Posted anonymously via Google Forms

Program: University of Wisconsin
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments:

Basics:
-Roughly 50 bed ED with 3 separate areas (north side/south side/peds)
-All private patient rooms with glass doors (occasionally there are hallway beds)
-Schedule includes a total of 16 shifts per month (7a-3p/3p-11p/11p-7a)
-You work a mixture of adult, peds, and teaching resident shifts
-Each area is usually staffed by an attending, 2 residents, and a med student
-Both verbal and Written feedback is provided at the end of each shift
-Rotation includes SIM sessions and U/S workshops

The good:
-Nearly everyone is very friendly and relaxed with only a few exceptions.
-Young energetic faculty with many just hired over the past 2 years.
-Big focus on teaching and EBM during shifts.
-EPIC access given to all students (allowed to pend orders and write notes).
-Good ownership of patients (opportunity for procedures and consults).
-Great EMS/Flight program (crown jewel of the program).
-Madison is a beautiful city (very family friendly).

The bad:
-Compared to other EDs UW is pretty slow with low acuity. They only see about 46K per year and some regular shifts felt like a fast track/express care shift at a busy inner city program.
-Below average trauma exposure. Nearly all blunt with very little penetrating. Trauma surgery runs the traumas while EM has the airway.
-No opportunity to ride on the helicopter. Normally not a big issue but it's a huge part of their program. They stopped letting students ride along after one of the helicopters crashed in 2008.
-Madison is not a big city and definitely has a lot less going on than other major midwestern cities (Milwaukee, Chicago, Indianapolis, etc...).

Overall a good rotation but Madison is definitely a learn by reading rather than a learn by doing type of program if that's your thing. Would be a great program for anyone interested in EMS/Flight who's looking to stay in the Midwest.

 

[deleted547339]

Guys and gals,

I'm don't know if this has been addressed earlier in the thread, but the whole premise of this thread is horribly flawed. Your goal on an away rotation is not to have a good time or even to learn. A *great* rotation means nothing and aiming for a great away is possibly counterproductive.

Only three things matter on away rotations. In order, 1) get a stellar sloe 2) get a shot at matching at that program 3) get a feel for that program. Nothing else matters.

Go to a program where you work 24 12a, hate the residents, don't get to do any procedures, never see an attending, get treated badly and don't learn anything? If it gets you a top 10% letter, it's the perfect rotation. Period.

 

[filhodeinferno]

.

 

[Cinematographer]

Had I done my first away at a program where "you work 24 12a, hate the residents, don't get to do any procedures, never see an attending, get treated badly and don't learn anything," then I would have seriously reconsidered my decision of going into EM, even if their SLOE was a stellar one.

For those whose med school does not have a home EM program, these types of reviews (be it from the upperclassmen at your school or forum like SDN) are pretty darn useful. Doing away electives (in particular out of state ones) can be expensive and exhausting, so why not find out where others have had a great experience to help you decide where to apply to? I agree that getting an amazing SLOE is the ultimate goal of doing an away elective, however. Thankfully, a good number of the reviews on here have touched on the quality of SLOEs as well.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: University of Nevada, Las Vegas
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: I didn't like it here. No feedback, scant teaching, and very disorganized clerkship coordination. 12 hour shifts. Mostly presented to a mix of PGY 2/3. Attendings didn't really want to hear from you for the most part. Residents were cool, there's definitely a bit of a a party vibe but there are some married folks too. I wasn't super enamored with the PD. I would not recommend rotating here but the residency seems ok for the right kind of person. Personally I will not be ranking it highly.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: New York Presbyterian (Columbia/Cornell)
Rotation: EM Sub-Internship
SLOE Provided: No

Comments: This is the residency program for Cornell and Columbia. You work two weeks at Columbia and two weeks at Cornell. Approximately 20 shifts that are a mix of 12's, 10's, and 8's. One shift of each: EMS ride along, peds, and urgent care. Roughly four overnight shifts. Each Wednesday is "off" for didactics which are mandatory and attended by all the residents; alternating between Cornell and Columbia campus each week. Pretty grueling schedule to be honest.

Columbia ED is a complete cluster ****. Basically one big room divided into two zones with patients only separated by curtains. Never a computer available for students and a terrible learning environment. Patients were regularly waiting 12 hours to be seen. Tons of hallway beds. Lots of Spanish spoken (huge Dominican Republic population). Nurses were overworked and there were lots of chances to place IV and roll patients to scanners, etc. Some of the worst patient care I've witnessed.

Cornell is a little better but not by much. They have one area that is brand new, one lower acuity area staffed mostly by PA's, and one area that is half rooms/half curtains.

The main problem with this program is that Cornell is on the upper East Side and Columbia is at 168th in Washington Heights...the commute is terrible at least half of the time depending on where you live. Residents seemed miserable working 12's plus the commute. Attendings and residents didn't teach much and I always felt like I was a burden.

Procedures: several lac repairs, many IV placements, US guided IV's, ABG's, cut a ring off, reduced a shoulder. VERY LITTLE TRAUMA in NYC comes to NYP so that was disappointing....maybe one activation per shift.

Residents: Didn't jive well with them. Very NYC centric group. Subsidized housing right next to Cornell is $2700 for a 1 bedroom.

SLOE: They don't write one. Instead, they assign you to a faculty member who writes you an individual letter based on feedback submitted by all of the attendings you work with that month. Unfortunately, I had never worked with this attending but scheduled a meeting outside of my clinical duties...it worked out fine and I still got a TON of interviews so not something to worry about. They give approximately 80% Honors (per the Sub-I director).

Overall: I do not recommend rotating here unless you absolutely want to live in NYC or are trying to decide if NYC is for you (coming from out of state). They are definitely strong academically given the double IVY association. Both ED's are kind of a disaster...especially Columbia. PD wasn't my favorite (could barely get a word in during the interview). They interview all Sub-I's during the rotation to save a trip back to NYC. No traditional SLOE but not really a problem.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Cook County
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: I really thought this rotation was overrated. Nationally the program has an amazing reputation, and I don't doubt that the residents receive phenomenal training. But I really regretted rotating here as a medical student and my experience convinced me that I don't want to rank this program highly (almost decided against going to the interview).

Didactics: You have department conference once a week. They are your typical run of the mill EM conferences with M&M, grand rounds etc. Med student lectures also occur about once a week (including one sim session). They were fine, nothing to go crazy about.

Shifts: I think you work 14-15 shifts over the course of the 4 week rotation. Shifts were 8 hours if I remember correctly. You are placed in one of the three pods (red, green, blue). Red has the highest acuity patients, including those in "Resus". As in most medical student rotations, you don't pick up these patients. But you are encouraged to go "and take part" which equates to "standing there and doing nothing". The rest of the patients on red are your typical county patients with decompensated CHF, rule out ACS, COPD exacerbations, "worst headache of life" and so forth. You push patients to the CT scanner because ancillary support and nursing is non-existent. Didn't bother me too much. I suppose you could draw blood and start IV's if you wanted to. Overall the nurses had a bad attitude which likely reflects working in an underfunded and overwhelmed county ED so you can't blame them. Green team is more like "fast track" which you will do a chunk of shifts in. Patients here aren't sick at all. Get to do some lac repairs and I&D's which was cool. Blue team is more intermediate, lots of undifferentiated abdominal pain, but again acuity is not as high as red. You will NOT see any trauma on your rotation. Cook has it set up so trauma is a separate department and the residents rotate through trauma individually. A huge disappointment because the trauma service here is supposedly really busy and exciting. One important point: the coordinator for the rotation is really helpful with scheduling around interviews so if you do it later in October/November they will likely accommodate you and shift stuff around.

Faculty: Most were pretty good. In the midst of the chaos of the department, they seemed to care about teaching when they could. Some of the faculty are very well accomplished and are well known in the field. But you work with different attendings every shift, don't get a chance to build any relationships with faculty (probably typical of most EM rotations). Again, faculty are busy and will forget about you often so you have to be pro-active about pushing patients to scanner, getting reads from radiology, following up on labs, calling consults etc. Sometimes the attendings will tell you "I'll be with you in 30 seconds" and then they get slammed and meanwhile you are worried that your patient has been waiting two hours to be discharged with PPI's and the attending just forgot. Definitely not their fault, it's just how it goes working in a busy ED.

Residents: You will only interact with the R4's who work in a "pre-attending" role and you present to them sometimes. While the residents were very strong clinically, most of them are too busy to acknowledge you. Not their fault, but I definitely found the residents here for the most part to be pretty cold.

Procedures: Other than some I&D's and lac repairs on the green pod, I didn't do any other procedures. This seems pretty common on most rotations, can't complain too much. I don't expect to be allowed to do intubations or put in central lines.

Grading: This was probably one of the stronger parts of the rotation. Each attending fills out an evaluation for you after each shift and you get an email when the evaluation is available so you can see how you did. Need to get an 83% to get Honors, 79% to 83% gets HP. There's no exam (unless you are a Rush student). Also graded on a short 5 minute presentation you give with the clerkship director and to the other students which is worth 1/3 of your grade (other 2/3 is your evals)

Housing: I lived in the area adjacent to the hospital, which is downright terrible. Don't live anywhere near the medical district or in the Tri-Taylor area west of the hospital. There is literally no groceries, shopping, fast food unless you want to get knifed. There is no night life and literally nothing fun to do in this area. I didn't have a car and had to walk everywhere or take the El. UIC and Rush students have been mugged and held at gun point. I would recommend staying in one of the nicer parts of the city and commuting if possible.

_____________________
Cinematographer's Note: This is the 3rd review I've received via GoogleForms for Cook County.

Thanks once again for everyone who has participated. And to those who have not participated, I once again remind you that this form is completely anonymous and open to both SDN users and lurkers. Help the rising seniors interested in EM find out where you had a great (or not-so-great) away elective experience.

 

[deleted547339]

Posted anonymously via Google Forms

Program: New York Presbyterian (Columbia/Cornell)
Rotation: EM Sub-Internship
SLOE Provided: No

Comments: This is the residency program for Cornell and Columbia. You work two weeks at Columbia and two weeks at Cornell. Approximately 20 shifts that are a mix of 12's, 10's, and 8's. One shift of each: EMS ride along, peds, and urgent care. Roughly four overnight shifts. Each Wednesday is "off" for didactics which are mandatory and attended by all the residents; alternating between Cornell and Columbia campus each week. Pretty grueling schedule to be honest.

Columbia ED is a complete cluster ****. Basically one big room divided into two zones with patients only separated by curtains. Never a computer available for students and a terrible learning environment. Patients were regularly waiting 12 hours to be seen. Tons of hallway beds. Lots of Spanish spoken (huge Dominican Republic population). Nurses were overworked and there were lots of chances to place IV and roll patients to scanners, etc. Some of the worst patient care I've witnessed.

Cornell is a little better but not by much. They have one area that is brand new, one lower acuity area staffed mostly by PA's, and one area that is half rooms/half curtains.

The main problem with this program is that Cornell is on the upper East Side and Columbia is at 168th in Washington Heights...the commute is terrible at least half of the time depending on where you live. Residents seemed miserable working 12's plus the commute. Attendings and residents didn't teach much and I always felt like I was a burden.

Procedures: several lac repairs, many IV placements, US guided IV's, ABG's, cut a ring off, reduced a shoulder. VERY LITTLE TRAUMA in NYC comes to NYP so that was disappointing....maybe one activation per shift.

Residents: Didn't jive well with them. Very NYC centric group. Subsidized housing right next to Cornell is $2700 for a 1 bedroom.

SLOE: They don't write one. Instead, they assign you to a faculty member who writes you an individual letter based on feedback submitted by all of the attendings you work with that month. Unfortunately, I had never worked with this attending but scheduled a meeting outside of my clinical duties...it worked out fine and I still got a TON of interviews so not something to worry about. They give approximately 80% Honors (per the Sub-I director).

Overall: I do not recommend rotating here unless you absolutely want to live in NYC or are trying to decide if NYC is for you (coming from out of state). They are definitely strong academically given the double IVY association. Both ED's are kind of a disaster...especially Columbia. PD wasn't my favorite (could barely get a word in during the interview). They interview all Sub-I's during the rotation to save a trip back to NYC. No traditional SLOE but not really a problem.

To the anonymous submitter above:

You say they are strong academically because of the association to Ivy League undergrad institution. This isn't necessarily true for EM residencies...

Just a point for other students. Don't assume that Yale or Hopkins or wherever are academically stronger than, say, Denver or Indy, etc.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: LAC+USC
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: This was one of my favorite rotations. You are paired up with a 3rd or 4th year resident. The 4th years are rockstars and run the department. The attendings are seemingly "consultants."

You work 120 hrs of 12 hour shifts, but you're able to work 8-10 hours on your night shifts. I ended up working 12 shifts when it all finished. Depending on what 2 week block your resident is on, it can be weighted towards nights. Best didactics out of anywhere I rotated or interviewed at. Tons of trauma, tons of procedures, and they'll let you pretty much do anything (probably not intubate). Definitely a busy residency. Residents work 12 hour shifts and many if not most shifts the residents were there for an extra 1-2 hours after every shift. You don't need to be fluent in spanish, but it helps. Residents were easy going and great to get along with.

 

[hoot504]

Posted anonymously via Google Forms

Program: LAC+USC
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: This was one of my favorite rotations. You are paired up with a 3rd or 4th year resident. The 4th years are rockstars and run the department. The attendings are seemingly "consultants."

You work 120 hrs of 12 hour shifts, but you're able to work 8-10 hours on your night shifts. I ended up working 12 shifts when it all finished. Depending on what 2 week block your resident is on, it can be weighted towards nights. Best didactics out of anywhere I rotated or interviewed at. Tons of trauma, tons of procedures, and they'll let you pretty much do anything (probably not intubate). Definitely a busy residency. Residents work 12 hour shifts and many if not most shifts the residents were there for an extra 1-2 hours after every shift. You don't need to be fluent in spanish, but it helps. Residents were easy going and great to get along with.

Just wanna concur with all that was said here. There's a lot of hyperbole thrown around on this forum (including from me) but the didactics here truly are next level. There are some personalities at this program that I will remember for probably the duration of my career. Mallon, Herbert, Swadron, etc. Seeing these guys in action is worth the price of admission alone. Biggest consideration if you're rotating here is where to live. Los Feliz or Glendale are probably the best options, they're close enough but far enough from downtown/skid row/LAC.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: East Carolina University/Vidant
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: 15-8ish (some random 7 or 9) hour shifts with a mix of P-side (higher acuity), G-side (lower acuity), and Peds. Didactics are protected days held separate for students once a week from 8-3 (hour lunch 12-1), which mostly consist of running a bunch SIM cases and some presentations. One day of practice procedures and airways. Required to do one 15 minute presentation with an additional powerpoint to be considered for Honors (it's no sweat). Also required to complete a ride along with local EMS. Really busy place with a HUGE catchment area with tons of variety. In three days, I saw a thoracotomy, aortic dissection, and compartment syndrome. Any patient is yours for procedures, can also pick up a few extra in your down time if waiting for labs or imaging if the residents need help. Paired with an attending or teaching resident for each shift. Evaluations done through form given to attending or teaching resident directly after the shift with verbal feedback usually given at the time. Mid block meeting also held to assess current status. Grading based on evals, presentation, SAEM exam, and a standardized patient exam. Tons and tons of teaching with a really friendly, down to earth faculty.

Greenville isn't the greatest city in the world, but it's not as bad as I expected. Some cool local spots if you ask the home students and residents where to go and only an hour from the beach. Really between 15 shifts, protected conference days, two test days, the ride along, orientation, and the practice procedure day there isn't that much time to explore anyway. They keep you busy, but in a good way. Home students and locals were also exceptionally friendly and welcoming.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Carolinas Medical Center
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: Work anywhere from 12-15 8-hour shifts with a mix of Major (high acuity), Diagnostics (lower acuity), AEC (fast track), and Peds. Conference is held every Thursday form roughly 8-12 with student lectures from 1-3 (range of practicing US, discussions, and formal didactics). That time is protected for the most part with the exception of working nights prior to conference, but not expected to attend after a night shift. Additional day of SIM lab.

Each shift is one-on-one with the attending or fellow. Any patient you pick up is yours for procedures, sign out, etc. Can pick up a few extra procedures in the higher acuity area where you have slightly lower expectations for carrying patients and can really help the residents more. A feedback link is emailed to each faculty member you worked with after each shift. Sometimes I would get direct feedback during the shift if the attending had time or an email response after I sent my link letting me know how I did and where to improve. A mid block meeting is held to review current evaluations and where to go moving forward. Grading is based mostly on evaluations with some small unknown percentage being from the SAEM exam taken on the last day. Incredibly busy shifts with a wide range of acuity and socioeconomic diversity.

Overall, incredibly well organized with a phenomenal faculty that is warm and excited to teach you, with 1 or 2 exceptions. Especially impressed with the Peds EM faculty. Residents were equally friendly and excited to work with you, get to know you, and hang out with you. Charlotte is beautiful and a fun city to explore in the time off you have. Really cannot say enough good things about this place in terms of the teaching and the overall experience. Would highly recommend going if you can, but be prepared to work hard!

Cons: No guaranteed interview, but that's not a surprise or a secret.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Dartmouth-Hitchcock
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments:

Positives:
- Quality faculty
- Above average didactics
- Exam at the end is a joke
- Plenty of free time in the schedule. I forget how many shifts but they're all 8s and there were plenty of days off during my month
- New Hampshire in the summer/fall
- Clerkship director (Hyde) and PD (Curtis) are just good people
- There may be some opportunities from the clerkship director to do some writing on EM topics for PEPID. Dunno if this is ongoing, I did a couple, it was interesting. It was a nice chance to get involved outside of shifts.
- I think rotating here opened up interviews at several Northeast programs that otherwise wouldn't have considered an out-of-towner like myself.

Negatives:
- Low acuity
- Next to no trauma
- Your only friend for the month might just be the moose that tries to block your drive into the hospital each morning
- No seriously, low acuity
- They don't interview during the rotation, in fact I'm not even sure if they interview everyone who rotates
- IMO there is really only one negative to this program and it can be summed up in one statement: I didn't see a single intubation during my month. Saw one CVC placement.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: MetroHealth/Cleveland Clinic
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: This was an absolutely amazing experience. You are paired with the upper level resident scheduled during your shift and work with them and directly with the attending. I thought all of the residents and attendings were compassionate, great educators and a lot of fun to work with. There are opportunities to get involved everywhere you look between the constant traumas and the complicated medicine patients. As a student you only rotate at MetroHealth (the residents do a third of their shifts at the CC) but have some lectures and the opportunity to go to a cadaver lab and practice all procedures (chest tubes, central lines, intubations, crics) at the Cleveland Clinic. Additionally there are teaching shifts scheduled with upper level residents where you get to work on whatever skills you want. There are additionally focused teaching days- ultrasound, SIM, eye stuff, mock oral board exams etc scheduled throughout the rotation. Oh and you get do a shift with LifeFlight, the helicopter EMS. I would highly recommend this rotation.

 

[bravotwozero]

Cook county. The trauma aspect is disappointing but otherwise you are doing a lot as a med student


Sent from my iPhone using Tapatalk

 

[Modafinil]

Posted anonymously via Google Forms

Program: Carolinas Medical Center
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: Work anywhere from 12-15 8-hour shifts with a mix of Major (high acuity), Diagnostics (lower acuity), AEC (fast track), and Peds. Conference is held every Thursday form roughly 8-12 with student lectures from 1-3 (range of practicing US, discussions, and formal didactics). That time is protected for the most part with the exception of working nights prior to conference, but not expected to attend after a night shift. Additional day of SIM lab.

Each shift is one-on-one with the attending or fellow. Any patient you pick up is yours for procedures, sign out, etc. Can pick up a few extra procedures in the higher acuity area where you have slightly lower expectations for carrying patients and can really help the residents more. A feedback link is emailed to each faculty member you worked with after each shift. Sometimes I would get direct feedback during the shift if the attending had time or an email response after I sent my link letting me know how I did and where to improve. A mid block meeting is held to review current evaluations and where to go moving forward. Grading is based mostly on evaluations with some small unknown percentage being from the SAEM exam taken on the last day. Incredibly busy shifts with a wide range of acuity and socioeconomic diversity.

Overall, incredibly well organized with a phenomenal faculty that is warm and excited to teach you, with 1 or 2 exceptions. Especially impressed with the Peds EM faculty. Residents were equally friendly and excited to work with you, get to know you, and hang out with you. Charlotte is beautiful and a fun city to explore in the time off you have. Really cannot say enough good things about this place in terms of the teaching and the overall experience. Would highly recommend going if you can, but be prepared to work hard!

Cons: No guaranteed interview, but that's not a surprise or a secret.

Good to hear! Let us know what we can do better for the next group! I rotated as a student as well, glad you had a good time.

 

[deleted720339]

Anyone who did an away at Denver care to comment on their experience? Thanks!

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Baystate Medical Center
Rotation: EM Clerkship
SLOE Provided: Yes

Comments:

Pros:
-All of the faculty and residents were cool
-Acted as an intern where you would manage your own patients, do your own notes, interact directly with an attending
-Solid didactics 2-3x per week for only the rotating students + weekly conference
-The residents invited students to go out with them to get drinks and they're a fun group
-Get a decent amount of procedures (lacs, intubations, I&D's) and they encourage you to play a role in the traumas that come in.
-They interview you while you're there in July, August, and September so you don't have to fly back during interview season.
-Apparently write great SLOE's as I had multiple people comment about the strength of my SLOE on interviews.
-15 8 hour shifts throughout the month I believe
-They provide housing next to the hospital for $200/month

Cons:
-Not many, I had a great rotation
-The city of Springfield, MA isn't the nicest area so it would be helpful to have a car to explore the surrounding area. visit Northampton, and go hiking.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Maricopa
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: Fun group, county experience, lots of interesting pathology happening probably bc it's Arizona. Embraced and taught well by the 2nd and 3rd years depending if you were on front or back shifts (front room was trauma or more critically ill). It helps to be a little laidback and not easily offended = fun. Maybe a little less teaching from certain attendings but they were easy to get a long with, hands off, and seemed to trust their residents' plans. Didactics run by residents. Not shabby. I think it's an up and coming program based off the energy. Organization of the elective might leave a little to be desired at the moment.

For the Sub I - ~14 total 8 or 9 hr shifts and attendance at weekly didactics, seems like you can work hard, get along, be decently smart and get high pass. We had 2 sim opportunities that were actually good during the month. 1 was an ultrasound shift. 1 was a triage shift. Grades come through faculty evals about you from each shift, you give 1 big presentation, you take a funky out of date test at the end (which probably prevents some honoring IMO). I don't know what they are known for in terms of turning out # of H or HP SLOEs, my HP did not in the least hurt me for getting some coveted interviews.

As for considering it for residency I like it but my misgivings are lack of female faculty, mentorship, academics being embraced by your attendings. The program seems pretty dynamic right now though and this could probably change if they wanted that. Positive Flipside : You can be really happy here if you are good at self directing, self motivating, and enjoy flexibility/freedom. The residents are great examples of that and are doing some cool national level stuff - public health, global health, EMRA rep.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Yale
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: I would not recommend rotating here. I was never scheduled a shift with the attending that wrote my SLOE. My very negative evaluation was based on 1 attending and 1 resident’s comments. I worked with probably 10 attending and 30 or so residents. I continuously got very positive feedback from attendings and residents alike, except the one attending and the one resident whose comments were included in my evaluation. There were a total of 4 comments on my evaluation.

More than a few of the students that were on the rotation with me received very negative evaluations as well. I just think that if you're going to write someone a negative SLOE; maybe you should have the courtesy to tell them that you don't think you'll be able to write a positive one.

Before anyone says "well, this is probably just a couple of bad students; they got what they earned", I honored my other two rotations which were both at solid programs. I also scored in the 99th percentile on the EM shelf.

Other students seemed to really enjoy the experience and had wonderful evals. Your mileage may vary. Also, SLOEs took two months longer to get than when they were promised to us.

They do have a wonderful ultrasound program; I feel like I learned more ultrasound at Yale than my other two rotations combined. I really liked many of the residents; they were really happy that students were there and they had an opportunity to teach. As far as attendings go, they have a couple gems. Some were really smart and wonderful. Some attendings (as per usual) weren't so interested in interacting with the students.

Conclusion: Yale's definitely a risky place to rotate if you need a SLOE.

_____
@Cinematographer's Note: My EM advisor is/was in the RRC and he/she had an expression of aversion in his/her face when we went through the list of places I was applying to. Yale was literally the one place to which he/she flat out told me "don't waste an application there."

 

[HooliganSnail]

To the anonymous submitter above:

You say they are strong academically because of the association to Ivy League undergrad institution. This isn't necessarily true for EM residencies...

Just a point for other students. Don't assume that Yale or Hopkins or wherever are academically stronger than, say, Denver or Indy, etc.

So True.

Community Unopposed EM programs is the best place to train. You get to do everything. No other specialty is coming down to steal your chest tube.

 

[deleted547339]

So True.

Community Unopposed EM programs is the best place to train. You get to do everything. No other specialty is coming down to steal your chest tube.

Not exactly what I said...

 

[lunalight]

Any other feedback about UCSF-Fresno in the last year or 2? I've seen only 1 mention of it so far from 2012. I'm setting up a rotation there for next semester. People seem to have positive things to say over in the ROL thread, curious to hear from people who rotated there vs just interview day. Thanks in advance!


Sent from my iPhone using SDN mobile app

 

[Cinematographer]

Any other feedback about UCSF-Fresno in the last year or 2? I've seen only 1 mention of it so far from 2012. I'm setting up a rotation there for next semester. People seem to have positive things to say over in the ROL thread, curious to hear from people who rotated there vs just interview day. Thanks in advance!


Sent from my iPhone using SDN mobile app

One of my classmates rotated there and absolutely loved it. I think she liked Fresno significantly better than the two other CA programs she rotated at.

 

[deleted720339]

I also heard great things from my classmates who rotated at Fresno and I really liked it on their interview day. Only major downsides were location and length of program, IMO.

 

[alpinism]

I also heard great things from my classmates who rotated at Fresno and I really liked it on their interview day. Only major downsides were location and length of program, IMO.

Personally speaking another one was that you're not allowed to see high acuity patients till 2nd half of R2 year.
(Unless they changed things recently).

 

[Rekt]

Is there a lot of competition for setting up audition rotations? I wouldn't be aiming top-tier anyway, since I'm a DO.