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

[Cinematographer]

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

First come, first served

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[lunalight]

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.

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).

Awesome! Thanks for the quick responses guys! Any other feedback about Fresno is still welcome.

P.S. Please keep the rotation reviews coming! I've been stalking this thread now that I'm applying for aways.


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[therunner12]

Bump.

For those that matched that want to talk up an away (or...the opposite).

 

[ERorPBR]

In light of some recent advice from individuals who did not match, could some people post where they had a *safe* rotation? (i.e. places that are known for providing good SLOEs)

 

[Cinematographer]

In light of some recent advice from individuals who did not match, could some people post where they had a *safe* rotation? (i.e. places that are known for providing good SLOEs)

Read the thread. There are literally 50+ reviews already answering that question.

 

[ERorPBR]

Read the thread. There are literally 50+ reviews already answering that question.

First off, thanks for all your work on this this thread. It has been immensely helpful. I have read and re-read the comments in this thread many times, but after your comment, I went through the entire thing one more time just to be sure. I counted exactly 10 reviews of places that mention anything about the SLOE. The vast majority of the reviews just have "Yes" next to the SLOE Provided prompt, and then make no mention of whether it was good, bad, detrimental to interview invites, etc--so I wouldn't count these as answering my question.

I still feel it is a fair question. It would be very helpful to have more examples of specifically which programs in the past have provided SLOEs that may have hurt candidates, or which programs tend to be safer. Again, thanks to everyone who has contributed to this forum.

 

[tastyb33f]

First off, thanks for all your work on this this thread. It has been immensely helpful. I have read and re-read the comments in this thread many times, but after your comment, I went through the entire thing one more time just to be sure. I counted exactly 10 reviews of places that mention anything about the SLOE. The vast majority of the reviews just have "Yes" next to the SLOE Provided prompt, and then make no mention of whether it was good, bad, detrimental to interview invites, etc--so I wouldn't count these as answering my question.

I still feel it is a fair question. It would be very helpful to have more examples of specifically which programs in the past have provided SLOEs that may have hurt candidates, or which programs tend to be safer. Again, thanks to everyone who has contributed to this forum.

I didn't rotate at either place, but word on the street is that Utah and Maricopa County are notorious for giving mediocre/crappy letters, no matter how hard you try and how much positive verbal feedback they give you. Happened to 4 people (2 at each site) in the couple classes above me. They all said that the attendings/APDs/PDs showered them with praise and "oh my gosh we'd LOVE to have you here!" and then got bad letters. It's not the biggest sample size, but still concerned me enough to dissuade me from going to either of those places.

My friend who rotated (and is now a PGY-1) at Cook County said it's difficult to get a good letter, moreso than other places, but not impossible. And hey, she Honored and matched there, so there you go! Again, sample size of one, so large grain of salt.

 

[Fox800]

I have consistently heard great things about Jacksonville and Christus Spohn.

I rotated at Hennepin and loved it, and if you search SDN you'll find that I'm not the only one. It's a great place. They have their own application and don't use VSAS, so I think a lot of people overlook it. Plus, they will take visiting MS3s to rotate in the spring of their third year. The only other place I know that does this is Christus Spohn.

I intentionally avoided rotating at Maricopa because of their reputation for writing harsh SLOEs.

I didn't apply to UT Austin because I had more than one upperclassman that was rejected without an interview despite rotating there and receiving great feedback. It seemed like your stock would more likely drop if you rotated there vs. just applying and not rotating.

I'd like to give a special thumbs down to programs that make you write a statement of interest as part of their rotation application. What a waste of time just to get rejected for a rotation. I'm looking at you, UNC.

 

[shodanmd]

Does anyone know if the google forms link to write a review still works? Was thinking of writing reviews on my aways from this season.

 

[mega_colon]

Does anyone know if the google forms link to write a review still works? Was thinking of writing reviews on my aways from this season.

Still works.

https://docs.google.com/forms/d/1mNyByXDKspfurNYDYORoHpNVQCCz69WUJpu1GjdqV9I/viewform?c=0&w=1

 

[Cinematographer]

I can confirm that UT Austin is a splendidly good choice if you are trying to ruin your application. Among the many horror stories I've heard, they apparently have no written feedback/evaluation system. At the end of your rotation the "faculty" get a generic email asking for comments. That's it.

 

[EMsleuth]

Lol damn, I had a great experience rotating at UT Austin and had an outstanding SLOE from them


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[KinesiologyNerd]

I'd like to give a special thumbs down to programs that make you write a statement of interest as part of their rotation application. What a waste of time just to get rejected for a rotation. I'm looking at you, UNC.

This and LORs have been a limiting factors in my search for aways. UNC especially since it's close to family. Duke OTOH will be hearing from me.

 

[EMsleuth]

I get that everyone wants a glowing SLOE and thinks they should be given such for electing to rotate at a program.. The best advice to garner a good SLOE is to bust your tail every single day that you work.. You're not going to honor a rotation by simply doing the bare minimum.. The whole concept of having standardized letters is to have a more objective evaluation, use it to your advantage

 

[Fox800]

I would strongly encourage you to talk to your upperclassmen and read this entire thread when you're picking a place to audition at. You want to rotate at programs that give you written feedback after every shift. Your senior resident or attending should sit down with you, write out your feedback on whatever form they use, and show it to you and go over it with you. That way you have a much lower change of getting blindsided by a bad SLOE after being told you were doing a great job all month.

 

[EMsleuth]

I would strongly encourage you to talk to your upperclassmen and read this entire thread when you're picking a place to audition at. You want to rotate at programs that give you written feedback after every shift. Your senior resident or attending should sit down with you, write out your feedback on whatever form they use, and show it to you and go over it with you. That way you have a much lower change of getting blindsided by a bad SLOE after being told you were doing a great job all month.

This is fantastic advice. Ask people that have been through the process and don't assume you know everything.


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[rowerontheriver]

In light of some recent advice from individuals who did not match, could some people post where they had a *safe* rotation? (i.e. places that are known for providing good SLOEs)

EM is still a pretty small community. When I was interviewing I got a few comments of "Oh, I know [soandso], their letters are typically *** and yours is ***". Be aware that if you look for a program that typically writes fluffy SLOEs, most PDs are probably aware of it and it may not help you as much as you hoped. Your best bet is to do what others are suggesting and ask to know what comments your evaluators are going to write, such that if something comes up, you can address it before the end of the rotation. If all you get is positive feedback at the end of a shift, it's never wrong to ask "based on what you saw today today, what is something I can focus on as a specific goal during my next shift."

If you get feedback on x in one shift, starting the next shift by telling your supervisor, "I've been trying to work on improving x, can we make that one of my goals for the shift" will go a long way and they may end up commenting on that subject in your eval (possibly negating the initial negative comment when the SLOE writer is deciding what to include). As a resident, when a student starts a shift with "today I would like to work on ****", 1- I see that they are motivated and engaged, 2- I can comment on that throughout the shift so they can learn. Whatever it is will also likely be brought up in the eval (hopefully seeing improvement), rather than me thinking too hard on what their other weakness were.

Just my two cents having gone through this and now being on the evaluating side.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: UCLA-Harbor
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: Rotated Fall of 2015. Overall an outstanding experience with an excellent and dedicated sub-I director who provides honest and helpful residency advising (he will meet with you 1:1 after reviewing your CV and etc to help you plan things), and offered to write a SLOE very quickly after the rotation (mine was submitted within 2 weeks after the rotation, and was instrumental in my getting other interviews). He is also very honest about whether he can write you a good SLOE or not, which I think is very fair and kind. Evaluations are done by index cards you give to the residents and attendings, and all of their feedback is considered in your eval--so it is very fair. At mid-rotation, they email you to update you on how many evals you have (to make sure you are getting enough for a fair eval), and also to let you know what evals generally say about you (so you can make changes and improve your performance); I appreciated this.

One caveat: rotating here (and even getting honors on this rotation) in no way guarantees an interview at this program, which I personally found upsetting and a bit surprising (particularly if you get honors, and put a significant financial and temporal investment into rotating at Harbor). Some of us who got honors emailed multiple times requesting interviews, and were denied--told that there were no spots left. Some had mentors from home institutions send emails, also to no avail. Then, an extra interview day was suddenly added at the very end of the season for people who rotated (which made many of us very happy!), but many applicants that day remarked that they were very surprised how unwelcome they felt at the interview day by residents and faculty who had been super cool to them during the rotation--so, all in all it was very unclear what this interview day really meant.

Back to the rotation itself: # of shifts and length of shifts was reasonable (I honestly forget the exact hours, but there is plenty of time to study and explore LA). You are paired with a 3rd year and an attending on most shifts, and you present first to the third year, who tweaks your presentation and sees the patient with you, and then you present to the attending. You write some notes and put in some orders (for co-sign by the resident), but the resident has to write a second note anyways, so some residents don't have you document. Pathology is diverse, and patients are usually grateful and interesting. Spanish is very helpful, but not mandatory. Trauma volume is moderate, and you are allowed to participate if the trauma is assigned to your team. Depending on the resident/attending, you can do most procedures under appropriate supervision, including LPs, central lines (if the patient is stable), lacerations, arthrocentesis, ultrasound etc. There are formal rounds at the beginning and end of each shift, where every patient on the board for your team is discussed. Its a great educational experience, because you get to present to the entire team, and the attending coming on will ask you questions and critique your management. Then, the attending gives a 10-15 minute mini-lecture, which is usually really awesome. You do 2 peds shifts and 1 EMS ride along (awesome...imagine driving at like 80mph in an ambulance down the wrong side of the freeway in LA traffic to a MVC with critically injured passengers) and 1 shift with nursing (which was a very valuable experience, both for IVs and also for meeting cool people), in addition to the adult shifts. You get free food in the cafeteria (not unlimited, but more than enough to eat there before every shift if you wanted). Parking is difficult, so you need to be careful about arriving early enough to get a spot. Beautiful modern ED.

Superb didactics (including dedicated med student simulation and lectures, suture lab, procedure lab, as well as the weekly resident conferences)

Attendings were literally all brilliant and excellent teachers. Many are super famous in EM, but were so kind and down to earth that you'd never know. Same with the residents. And all of them have particular styles and areas of interest, so you get to see different approaches to the same problems. Also, nurses are really nice and will support you and offer to help you with stuff, which was great. They are totally willing to let you put in IVs and etc if you want, and will even do it with you if you want (or they'll do it no problem if the order is in the computer); they are also used to med students, so they treat you like a colleague if you treat them the same. And even consultants were pretty cool...one of the neurosurgery residents gave me a mini-lecture on cord compression, a urology resident taught me about testicular torsion, ortho showed me how to reduce a tib/fib fracture and do a hematoma block, and the trauma attendings would show me stuff all the time. Just a lot of nice and smart people who are good to be around; everyone seems excited to be there, which was honestly inspiring.

So overall, I would highly recommend the Harbor-UCLA sub-I. I had a wonderful experience, learned a ton, solidified my career choice in emergency medicine, and got even more interested in taking care of vulnerable populations. I also feel like I grew alot as a clinician, and feel much more confident when working in other clinical settings since that rotation. I also got a great SLOE very quickly after the rotation (which I really appreciated and did not expect), which truly helped me get many interviews that I really wanted. I just would warn people that rotating here does not guarantee an interview, even if you get honors; if you have ethical issues with this, or really need to get an interview every place you rotate, maybe discuss this with your home-institution advisor to decide what the best course of action would be...

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Virginia Commonwealth University
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: 1 orientation shift with procedure lab and lectures, 12 8-hour shifts, 1 12-hour pediatrics shift, 1 toxicology shift, 1 12-hour EMS shift, 1 10-hour CDU shift. Grand rounds, journal club, and resident conference are optional.

Sign up and see patients independently. Expected to put in all orders including labs and medications. Expected to perform all procedures on patients. Expected to document completely. Present directly to attending. Very friendly residents, staff, and attendings. No guaranteed interview.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: LA+USC
Rotation: EM Clerkship
SLOE Provided: Yes

Comments: This was hands down my favorite rotation I did out of my 4 aways this year. Students work at least 120 hours the whole month (roughly 10-12 shifts) and are paired with two 3rd or 4th year residents. As someone mentioned previously, you spend two weeks with one resident working their shifts before switching off with a different resident for the second half of the month. I liked being evaluated this way because you really got to know the residents and I felt they could better evaluate you over the 4 week period. Since you work the shifts of the senior residents, you get a mix of nights and days as well as a mix of the different pods. At LA-USC there are 5 different pods that students work: Resus (Trauma/CC), North (higher acuity), East (fast track) and Peds. Students can also work the Jail ED, which is underneath the hospital and caters to the inmate population in LA County. It has all the resources of the main ED and sees all but the sickest inmates. The jail shifts, which were optional, are something really unique to LA-USC and were some of my favorite shifts, since its essentially just you and the resident working together. Didactics, which have been mentioned previously, are outstanding. Some of the brightest minds and thought leaders in the field of EM are at USC so seeing them in person is really impressive.

From the beginning of the rotation, the program coordinator makes it clear that they want to you to get more out of the rotation than just a SLOE. They have an advising BBQ for all the rotators at the PD's house that is attended by residents where they answered any and all questions about the application process. This was the only place that I went that did this and I really appreciated all of the advice. As for procedures and clinical experience I did many lac repairs, 2 paras, assisted with several central lines and did quite a few FAST exams. While I was there I saw 2 thoracotomies, multiple chest tubes, intubations etc. There was definitely no shortage of ways to get involved as a student. I would highly recommend rotating here if you can get a spot.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Mt. Sinai St. Lukes-Roosevelt
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: This was my second and favorite EM SubI out of the 3 I did. The schedule consisted of 14 clinical shifts split between St. Luke's and Roosevelt (mostly all 10 hr shifts) as well as an EMS shift. Each shift you are the only student assigned to that attending which makes for amazing teaching as well as a significant amount of autonomy as the shift(s) progress. Plenty of procedures: IVs, suturing, ortho, maybe even an LP or CL depending on the day/who is around. The acuity was great, I think I had at least 1 MICU consult/shift ( obviously this is dependent upon the day but overall I was impressed with the acuity/pathology and never felt like students were prevented from seeing sick pts). There are well more than enough patients to go around so that was never an issue. Luke's is a trauma center and during the traumas the students are encouraged to observe/assist ( this is again situation/trauma dependent but I was able to put multiple IVs in during the resuscitations/traumas and assist in secondary surveys..etc) The third years run the resuscitations/traumas ( with the attending nearby/in the bay) and to be honest they were all rockstars. At the end of each shift, the attending fills out an online evaluation for you similar to the SLOE format which is compiled at the end of the rotation to make your SLOE. You are also assigned at least one shift with one of the two clerkship directors ( both of which are amazing) so that they can have a basis to compile the rest of your evals on. The residents love having students around to teach and are always willing to help you go over a pt before presenting to an attending. They also spend a lot of time outside the hospital together and go out of there way to invite the rotating students to spend time with them at the end of the clerkship. The weekly conference day is Wednesday mornings which all residents, students, and a large number of faculty attend. In addition, there are student didactics interspersed throughout the rotation and at the end of the rotation there is a 50 question "step 2 CK" style exam.

Overall: Fantastic rotation that is really welcoming to students. You will have as much or as little autonomy as you desire and I feel that your SLOE is a fair and accurate representation of how you overall preformed on the rotation. I absolutely recommend this rotation to anyone who wants a rotation in a high volume inner city ED(s), although I would say as your second EM SubI because they will give you a signifcant amount of autonomy if you feel confident and take it.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Maimonides Medical Center - Brooklyn, NY
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments:
Pros:
-Extremely busy community program in between Borough Park, which is almost entirely Orthodox Jewish, and Sunset Park, which is China. Extremely diverse population (Russian Jews, Chinese, Middle Eastern, etc) = diverse languages and cultures
-Average ED pt age is 10-15 years older than national average = lots of comorbidities = super sick people = learn critical care really well.
-Maimonides Peds will soon be the only Level I pediatric trauma center in Brooklyn.
-One of the best student- and education-centric rotations I did - lots of formal student teaching - learned tons! All the faculty responsible for the student rotation are nice, great at teaching, wonderful people.
-Rotation includes a few Peds shifts in their Peds ED!
-Every conference day includes 2 hours of small group discussion re: assigned readings and homework - forces you to learn, and fast.
-Great opportunity to do procedures (intubation, central line, etc.), since seniors have done so many that they’re happy to hand them off to students
-All students are automatically interviewed while on rotation! Saves you a trip back.
-Wellness is highly emphasized and taught here!
-All interns go to SAEM conference
-Very safe area of NYC

Cons:
-EMR is awful.
-ER and equipment is REALLY outdated and cramped. By cramped, I mean the beds are literally guardrail to guardrail and three beds deep from the wall. Nurses play a lot of Tetris to get beds in and out. It’s a very “do more with less” type of place.
-End of rotation includes the stupid SAEM standardized final exam. Awful outdated questions.
-Diversity of languages makes English the least useful language; frequent use of interpreters or language phones slows down work.
-Trauma is weak here. 1 month of Trauma in intern year at Shock Trauma in Baltimore (website says 2 blocks in PGY-2; that is outdated), and then occasional trauma rotations at Brookdale in PGY-3. Otherwise, no trauma.
-High cost of living - not as $$$ as Manhattan, but still.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Jacobi/Montefiore - Albert Einstein College of Medicine
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments:
Pros:
-Split time between Jacobi, the NY public hospital serving the North Bronx, and Montefiore, the university hospital of AECOM - 2 weeks at each
-Jacobi: busy county hospital. Adult ED 75k annually, Peds ED 40,000, sees lots of trauma - ED runs every single trauma except Level 1 is split w/ trauma surgery. Students present to senior residents.
-Jacobi is also the only Hyperbaric Center AND Snakebite Center for the Tri-state area (NY, NJ, CT)!
-If Dr. Michael Touger is still there, he leads a field trip to the Bronx Zoo every rotation to learn about snakebites!
-Montefiore (“Monte”): super busy community hospital (Adult 80k annually) w/ very high acuity that includes CHAM (Children’s Hospital at Montefiore); sees no trauma. Students present directly to attendings at Monte.
-Jacobi = Opportunity to do tons of IVs - see first note re: NYC ancillary staff under “Cons.”
-State of the art sim center at Jacobi; students do 1-2 sim sessions
-All visiting students are guaranteed an interview - first interview day of season is reserved for them

Cons:
-Nursing and ancillary staff in NYC public hospitals are generally worse than other areas of the country - they’re understaffed, overworked, and because the nursing union is so strong, many of them aren’t as proactive as they could be. This means residents end up doing some scutwork (IVs, moving pts). Having said that, however, Jacobi’s nurses are better than most other NY public hospitals, and Monte’s nurses are phenomenal.
-not necessarily a con, but: intense experience - all shifts are 12 hours = exhausting
-Monte is like 60% Spanish-speaking patients. Hope you’re fluent!
-Jacobi’s EMR sucks. (But Monte just switched from T-sheets to Epic)
-Students don’t do any Peds shifts
-Parking is great at Jacobi but unavailable for visiting students at Monte. There is a shuttle between the two that runs q 30min
-Multiple choice in-house final exam, but not a definitive part of your grade (e.g. I scored below the group average but they gave me Honors anyway due to strength of my clinical evals)

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Boston Medical Center (BU)
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments:
Pros:
-Busiest ED in New England - 130K visits/year (including Peds ED). Wide array of pathology that serves South End/Roxbury/South Boston.
-Boston is New England’s, and possibly America’s, epicenter of the heroin epidemic.
-Major emphasis on social welfare, violence prevention, substance abuse recovery, all through the ED. BMC is an international pioneer and THE model for other hospitals in this arena!
-On shift, there are two pods where you report to senior and one pod where you report directly to attending.
-THEY USE EPIC!
-During EM shifts, PGY-2s are the “Procedure Residents” - they do every single procedure in the ED (I&Ds, scopes, ultrasound IVs, paracentesis, whatever) - and students do a couple of these shifts! = lots of opportunity to do procedures!
-Inpatient Peds during residency is at Boston Children’s - pretty unbeatable
-8 hour shifts!

Cons:
-No Peds shifts on student rotation
-Kinda hard to schedule shifts with Kerry McCabe, the Program Director
-Cost of living in Boston
-MBTA (“The T”) isn’t the most reliable
-Procedure Shift can be quite insane - seeing patients while getting paged for procedures

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Denver Health/U of Colorado
Rotation: EM Clerkship
SLOE Provided: Yes

Comments: This was an overall awesome rotation! Although it is not labeled as an AI, it was the closest I felt out of all my med schools rotations to being responsible for the patients I was carrying. Here you do 18 8-hour shifts broken into 13 at Denver Health (county hospital) and 5 at UC (university hospital) or vice versa (13 at UC and 5 at DH, you get preference if you email them early enough, although it doesn't make much difference). At this rotation no one holds your hand and you are expected to know how to suture and how to approach bread and butter EM complaints. You are expected to write orders for i.e basic labs (UA, CBC/BMP), EKG's, CXR before presenting the patient to the Senior to expedite the process. I would not recommend doing this rotation without any prior ED experience.

They have a weird EMR at DH (emesis) which is 75% paper and 25% electronic which takes a couple of shifts to get used to although they switching to EPIC for all sites by early 2016 so no problems there. What impressed me the most was the competence level of their 4th years. The Senior is expected to know what is happening with every (usually 50+) patients in the ED. Every one of them knew their stuff really well and they were all just starting out 4th year too. I have a lot of respect for the quality of the residents they produce. Not a malignant program at all as people make it out to be; the interactions between residents and faculty were always really good; Never saw any1 being put down. They do work a good amount though (22+ 8 hour shifts) a month, but by the time they graduate they all advocate this amount as they feel extremely prepared. Denver as a city is great too! I would sometimes walk home the 2 miles and in the middle of July to not break a sweat says a lot!

The program does get a competitive pool of MS4s rotating there, which makes standing out difficult unless you've already done other EM rotations. In other words, this is not the type of place that hands Honors to everyone.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: University of Missouri Kansas City (Truman Medical Center)
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments: 15 shifts total I think. 8.5 hrs with signout. Includes one nursing and one EMS shift. Let them know what days off beforehand and they accommodate pretty well.

Work mostly with a third year during each shift but graded by faculty member. Had to present to faculty on at least two patients and write two notes that they would review. Two doesn't sound like a lot but a couple shifts I struggled to get to see two patients (boarding in ED, competing with intern, and sometimes your third year and attending only share 5ish rooms so that's all you can pick your patients from). I got more of a pimping vs. teaching vibe from the faculty. Every program has the 1-2 attendings that are complete A-holes. The one here was the worst I encountered during my audition travels.

I did about 5 simple laceration repairs and 3 I&D's for procedures, which was more than what the other students my month had. Doubt they would let a student do a central line or intubation.

Pathology was typical of inner city/underserved. PCP is the local drug of choice. I hadn't had much experience with it before so that was interesting.

Given iPad mini with educational resources on it. I liked having the iPad, but was in constant fear of losing it lol. Also wrote your patient notes on the iPad.

1-2 lectures a week for students. The material was definitely geared towards beginner EM which I thought was appropriate for me (AMS work-up, chest pain differential, intro to toxicology). One thing I really liked was that the PD and APDs let you ask them advising questions. This was super helpful to me since I don't have a home program and no one at my school is in the EM game.

SLOE was completed by the program less than 2 weeks after I finished. Everyone is concerned about bad letters, but no one told me anything about this letter in my interviews so I have no idea what it says. I actually don't even know what grade I got for this rotation because my school lists our elective grades as P/F and wouldn't tell me what my actual grade was. They are pretty neat like that.

Pretty sure all rotators get an interview invite, but you aren't guaranteed a spot. You have to schedule it on Interview Broker before the plebs that didn't rotate take all the spots.

Housing: I used rotating room. $500 for the month.

ED experience: B
Other stuff: A-

 

[Cinematographer]

Alright, I can tell that there are many (new) MS3s lurking/posting on this subforum who are incredibly thirsty for these types of reviews. I will continue to post them, but keep the following thing in mind:

Realize that these reviews are being submitted by a fraction of all the students rotating at any given program. As such, the information on this thread is prone to significant selection bias (e.g., people who had a horrendous or outstanding experience are more likely to speak up than those who had the average experience you get out of rotating at a certain program). So, don’t let a single negative review of a program dissuade you from rotating there, as it might be an isolated case. One would need multiple negative reviews of that rotation site before you could conclusively say that it's best to avoid it.

As people have commented here and elsewhere: the best way to guarantee a strong SLOE is by working hard, being motivated/eager to learn, and asking for timely, frequent feedback. Not by obsessing over these reviews.

 

[TBoneKoko]

Just wanted to pass along some friendly advice to current M3's setting up away rotations.

Around this time last year, I had no idea how strong regional biases would be when applying to programs.

I know it's entirely anecdotal, but my own numbers:

1 home rotation (Midwest)
1 away rotation (Northeast)

Applied to 7 programs in the West, offered 2 interviews (29%)
Applied to 14 programs in the South, offered 4 interviews (29%)
Applied to 25 programs in the Midwest, offered 21 interviews (84%)
Applied to 6 programs in the Northeast, offered 6 interviews (100%)

I know a few friends who had similar experiences. If you're hoping to match somewhere across the country, I would strongly recommend doing an away rotation in that part of the country.

 

[Cinematographer]

Posted anonymously via Google Forms

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

Comments: I would strongly recommend avoiding Cook County as an away rotator. The SLOE will reflect your grade on a 5 point scale (H, HP, P, etc.), and it is difficult to get High Pass or Honors as a visiting student. Rush students on a home rotation are heavily favored as they have the shelf score factored into their score, while as an away rotator your grade is based entirely on subjective evals. Most of my preceptors did not fill out evals reliably, and even when they had no suggestions for feedback in-person, or even when I received praise and highly positive feedback to my face, the numbers I received did not work out to the very high levels required for HP or H. The SLOE is also notoriously tersely written and doesn't provide much info to programs you apply to. You also get zero exposure to their famous trauma area during the month. Finally, I had absolutely no opportunity to provide formal anonymous feedback on the way the clerkship was run, which I feel is a hallmark of a quality-run rotation.

Positives for the program: Rotators can pick up patients on their own, enter diagnostic orders without co-signatures, and staff with attendings. You get exposure to a high-acuity inner city population. The clerkship coordinator is very friendly and helpful and can set you up with housing. You work I think about 15 to 16 8-hour shifts during the month, which leaves you plenty of time to explore Chicago.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: SUNY Downstate/Kings County
Rotation: EM Sub-Internship
SLOE Provided: Yes

Comments:
Pros:
- Great residents and attendings
- down to earth, variety of backgrounds
- Busy - lots of pathology, "just arrived to the US have never seen a doc" cases
- Good trauma by NYC standards
- Kings county ED; newish, critical care trauma section (~ ED ICU)
- Good opportunities for procedures for students
- Brooklyn
- Students do 8hr shifts, decent flexibility in terms of scheduling
- Rotate through all sections of ED (peds, trauma, main, fast track...)

Cons:
- Sometimes it's too busy for residents and attending to teach
- Occasionally there are multiple students scheduled for shifts in the same area
- Nurses are pretty swamped especially at Kings -> you get to do a lot of IVs
- Downstate ED (25% of your time) really needs a facelift
- Brooklyn housing prices

 

[Cinematographer]

I changed the SLOE dropdown menu (3rd question on the Google Form) to reflect some of the feedback that I've received on how to improve the usefulness of the anonymous reviews. But, once again, please keep in mind (quoting myself from previous post):

Realize that these reviews are being submitted by a fraction of all the students rotating at any given program. As such, the information on this thread is prone to significant selection bias (e.g., people who had a horrendous or outstanding experience are more likely to speak up than those who had the average experience you get out of rotating at a certain program). So, don’t let a single negative review of a program dissuade you from rotating there, as it might be an isolated case. One would need multiple negative reviews of that rotation site before you could conclusively say that it's best to avoid it.

As people have commented here and elsewhere: the best way to guarantee a strong SLOE is by working hard, being motivated/eager to learn, and asking for timely, frequent feedback. NOT by obsessing over these reviews or requesting for the reviews to include more specifics about SLOEs

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Scott & White (Texas)
Rotation: EM Sub-Internship
SLOE Experience: Submitted in a timely manner

Comments: There were about 15 other medical students on rotation with me but you never step on each other because there are 3 teams and you are assigned your own upper level resident to follow; very nice residents and affable attendings. There were 40 residents total (14 being interns). I would guess that there were less than 20 attendings, probably closer to 15. This was helpful in that by the end of the rotation everyone knew you by name.

You attend Resident lectures on Thursday mornings where they provide good breakfast. The lectures are mostly resident led and pretty entertaining (lots of humor). Once a week you have SIM lab training where you are thrown into a simulated situation (ex. patient found down, limited history) and you and your team have to figure out how to treat. You also have to do 3 short presentations 1 on 1 with either a resident or attending of your choice. One of the 3 must be presented at the end of the rotation for a grade. I was able to find a place to stay by emailing the coordinator and she sent me a list of people who you can stay with. For 4 weeks, I was able to stay with an orthopedics resident and his wife for 400 bucks with my own room and bathroom in a brand new home.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Denver Health/University of Colorado
Rotation: EM Clerkship
SLOE Experience: Sent in a timely manner

Comments: Beware, this review is coming from a current EM resident who rotated at this program ≥2 years ago, so some of this information might be outdated.

You do approx. 18 (?) 8 hour shifts (7a-3p; 3p-11a; 11p-7a). You attend resident lectures on where they provide good breakfast. They provide you with a resident mentor and an attending mentor. My mentors were very good and I liked them a lot. My attending took me out for coffee for an hour before a shift just to chat. The residents (as well as some of the attendings) really make you feel welcome. Several times after getting off shift, we went out for pizza and beer or tacos. Once a week, the interns will go out to dinner with us (this might depend on the time of the year you rotate, though, not sure). This is a tough place to get a strong SLOE from. They tend to grade pretty hard given the type of visiting medical students it tends to attract. Having said that, this program is not malignant despite some unfounded claims on SDN (for reference, malignant to me is defined as a program that belittles, verbally abuses, unfairly criticizes its residents and/or does not respect hour caps). Maybe they were malignant when they were under the department of surgery, but that was ≥5 years ago.

As a city, Denver is one of the prettiest places I’ve ever been. I stayed close to the zoo/city park and was able to run 5x/week. On your days off you can drive to Boulder, Fort Collins or explore Denver.

At the end of your rotation the medical students are split into 2 different groups and are assigned a topic to debate. Your grade is based on this debate, SAEM exam after the rotation, and resident evaluations. I was ‘interviewed’ during my rotation which consisted of a 30 minute meeting with the director. If you rotate here, your rotation IS your interview, so do well.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Christus Spohn/Texas A&M Program
Rotation: EM Clerkship
SLOE Experience: Sent in a timely manner

Comments: I absolutely loved this program! Everyone is super friendly and you get lots of face time with program higher-ups, or at least I did. You work 13-ish 9 hour shifts and the last hour is overlap with the on-coming team. There is only one student scheduled per shift and you generally work directly with faculty or with the upper level on the team. Christus Spohn is a county hospital and while they aren't a designated Level 1 trauma center I saw just as much, and in some cases more, crazy trauma than my other aways and home institution. This is a high volume fast-paced ED where the physicians care about patient wait times (not the case at all places) so you will see a lot of patients. These patients are quite sick so you will get practice at managing complex care. The EMR is not so good - they only use it to put in orders and do discharge instructions, all notes are done on T-sheets (pretty nostalgic if you were ever a scribe, a bit overwhelming at first if you have never seen them).

There is weekly didactic from 7-noon that you attend with the residents. There is a disease checklist, a procedure checklist, a presentation, and an in-house test that must be completed by the end of the rotation - very manageable because you see so many patients.

This is a very hands on rotation - you will do lots of procedures, and not just lac repairs and I&Ds. The faculty absolutely love students and will want to get you involved in everything. Thus you should show up to every shift armed with Trauma shears because you will involved in all of the traumas. The ED Chair officially writes your SLOE but input from all faculty is added so it goes in as a group SLOE. Housing is provided through the rotation and while I shared an apartment with 3 other girls it really wasn't too bad - 15ish min from the hospital and 15ish min from Padre island. The faculty and residents are a big family here - they often hang out, grab food after shifts, and even do cross-fit together, all of which the rotating students are invited to. There was also plenty of time to explore Corpus.

Particular pros: I went wind surfing a few times and got to see baby turtles get released to the wild. Overall this was one of my favorite months. The program is very inviting and everyone seems really happy, not something that can be said for some of my other aways.

 

[IH8ColdWeath3r]

Anyone care to comment on UT Austin Dell, UMKC (Kansas City), or UNMC (Nebraska)

Was Austin Dell that bad of an experience and is their feedback based on a generic email. I would love to live in Austin and Brackenridge seems like a great place to train, but honestly I'm a bit turned off after all of these negative reviews. Did anyone have a positive experience there?

 

[Cinematographer]

Avoid. Austin.

Probably the only place that I can personally say is worth avoiding.

 

[IH8ColdWeath3r]

Avoid. Austin.

Probably the only place that I can personally say is worth avoiding.

Thanks a lot for the honest advice bud, I appreciate it. Sad because all things considered, it seems like a great city and place to train, but after seeing the reviews and input I am going to take the advice since it was put forth by so many different people who went there.

 

[Fox800]

Anyone care to comment on UT Austin Dell, UMKC (Kansas City), or UNMC (Nebraska)

Was Austin Dell that bad of an experience and is their feedback based on a generic email. I would love to live in Austin and Brackenridge seems like a great place to train, but honestly I'm a bit turned off after all of these negative reviews. Did anyone have a positive experience there?

+1 to avoiding Austin. I heard from two upperclassmen that they got great feedback on their auditions (including one that the PD told "see you this fall!") then were rejected during interview season. You can only hurt your chances at that program by auditioning there.

Also, I see that you're a DO student (me too). The UT Austin system is cultivating an anti-DO bias, thanks to their new dean. You see, they don't want DOs at their residency programs because it tarnishes their (brand-new and unproven) reputation...

 

[IH8ColdWeath3r]

+1 to avoiding Austin. I heard from two upperclassmen that they got great feedback on their auditions (including one that the PD told "see you this fall!") then were rejected during interview season. You can only hurt your chances at that program by auditioning there.

Also, I see that you're a DO student (me too). The UT Austin system is cultivating an anti-DO bias, thanks to their new dean. You see, they don't want DOs at their residency programs because it tarnishes their (brand-new and unproven) reputation...

Wow, that sucks.

 

[Got Em]

Anyone rotate at these places?

1) Tufts - Good Samaritan, Tufts Medical Center, or St. Elizabeth
2) Univ of South Florida
3) Danville

 

[discostu42]

+1 to avoiding Austin. I heard from two upperclassmen that they got great feedback on their auditions (including one that the PD told "see you this fall!") then were rejected during interview season. You can only hurt your chances at that program by auditioning there.

Also, I see that you're a DO student (me too). The UT Austin system is cultivating an anti-DO bias, thanks to their new dean. You see, they don't want DOs at their residency programs because it tarnishes their (brand-new and unproven) reputation...

While I don't disagree with any of your sentiments regarding UT Austin's approach to aways/interviews/SLOE's, a look at their website shows that the class of 2018 has 4 DO's in it. I don't think we can necessarily comment that they have any anti-DO sentiments, particularly in light of this.

 

[Cinematographer]

While I don't disagree with any of your sentiments regarding UT Austin's approach to aways/interviews/SLOE's, a look at their website shows that the class of 2018 has 4 DO's in it. I don't think we can necessarily comment that they have any anti-DO sentiments, particularly in light of this.

The class of 2018 interviewed prior to the hiring of the new dean and opening of the new med school. Your point of view would have been closer to reality if we were still in 2014.

All in all I'm finding the interest in this low tier, new program a bit unfortunate. But "location, location, location..."

 

[Fox800]

While I don't disagree with any of your sentiments regarding UT Austin's approach to aways/interviews/SLOE's, a look at their website shows that the class of 2018 has 4 DO's in it. I don't think we can necessarily comment that they have any anti-DO sentiments, particularly in light of this.

The class of 2018 interviewed prior to the hiring of the new dean and opening of the new med school. Your point of view would have been closer to reality if we were still in 2014.

All in all I'm finding the interest in this low tier, new program a bit unfortunate. But "location, location, location..."

Cinematographer is exactly right. This is a new change with the hiring of the new medical school dean. All of my classmates that applied were rejected except one that auditioned there. Their days of being DO-friendly are over, as every medical student and their dog is interested in moving to Austin.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: UT Austin
Rotation: EM Clerkship
SLOE Experience: Sent considerably late

Comments: I'm seeing a lot of posts about this program from some seemingly naïve MS3s, so I decided to use the Google form to comment on my experience rotating at this program.

The rotation itself is rather enjoyable and laid back. I liked the residents and some of the faculty. However, most faculty are not interested in hearing you present, and your participation is limited (for the most part) to the lower acuity side of the ED. It honestly felt like I was redoing my FM clerkship, just with odd hours. Almost no procedures, which I found to be a bummer.

I did get a decent SLOE from them, but that probably means I was lucky enough to have one or two faculty respond to the end of rotation generic email that is sent out to everyone in the department to evaluate you. Honestly, had I known that they do not have a formal written evaluation system and/or mid-point feedback session, I would have not even considered rotating there. It's just to risky to rotate here.

As others have echoed on this thread before, rotating at UT Austin is no guarantee that you will get an interview invitation from them. In my case, I received a rejection email.

I rotated at two other programs, both of which are considered top tier community and academic programs in EM, respectively. UT Austin seemed exceedingly mediocre and half-assed after doing my other two rotations. I'm sure the residents from this program will turn out to be competent ER docs, but in terms of didactics, academic opportunities, alumni network, trauma/high acuity exposure, this program is as low tier as it gets. It's no wonder the residents answer "Austin" whenever you asked them why they chose this program; there really isn't anything else remarkable about or decent about it.

 

[Cinematographer]

Posted anonymously via Google Forms

Program: Newark Beth Israel
Rotation: EM Sub-Internship
SLOE Experience: Sent SLOE Considerably Late

Comments: I didn't see too many "avoid this place like a plague" postings so I'll contribute. I rotated at this place and it was the biggest mistake of my application process.

First of all, the ratio of students to preceptor was out of wack. The student coordinator in charge of accepting students for away rotation was apparently out of office for a long time, so they accepted everyone who requested the rotation. This left the hospital with way more students than they could handle. For every shift, I had at least 2-3 other students in the same ED pod. This created a sense of competition among the students because they paired 2-3 students to 1 resident. You are already stressed enough because you are auditioning...last thing you want is other students gunning against you. When you rotate at other hospitals, you'll notice that they pair you up 1:1 with attending physicians. This is how you will be evaluated properly, not when you are with other students following the same resident around. Don't get me wrong...most residents were nice people. They also seemed very competent at what they were doing. But the residents were often frustrated because they had to take care of 2-3 med students. I don't blame them because I would be annoyed too if I was in their shoes. Oh, and don't expect to work with the attending physicians too much. There are 2-3 attendings at most who genuinely care about the student's experience... the remaining attendings don't give a flying crap.

Second issue also goes hand in hand with the first. Because there were too many students, it took a LONG time for the PD to write SLOE. Personally, it took them almost 4 months to upload my SLOE. I was literally like WTH?? when they uploaded the letter towards the end of the interview season. You'd be thinking how all this mess can happen in one rotation site, but it ain't over yet. I'm not sure if other schools have a separate evaluation form (not SLOE, but required for every rotation by school) to be submitted...but beware if you do need one. They NEVER submitted my form to school and I was in danger of failing the entire rotation. I wish I can say that I was the only victim, but I know at least 5 other students who's had SLOE and evaluation issues. I'm sure other students who rotated here will at least partially agree with what I said.

I understand that the hospital is doing med students a favor when they allow students to rotate and provide SLOE. But stating that they will, and not abiding by that statement is basically making false promise. For them, we might be "just another med student," but for med students each audition rotation is a big deal that can make or break your future career. I just hope that Newark Beth Israel can think about this one more time before actually ruining anyone's lives.

 

[Apollyon]

Posted anonymously via Google Forms

Program: Newark Beth Israel
Rotation: EM Sub-Internship
SLOE Experience: Sent SLOE Considerably Late

Comments: I didn't see too many "avoid this place like a plague" postings so I'll contribute. I rotated at this place and it was the biggest mistake of my application process.

First of all, the ratio of students to preceptor was out of wack. The student coordinator in charge of accepting students for away rotation was apparently out of office for a long time, so they accepted everyone who requested the rotation. This left the hospital with way more students than they could handle. For every shift, I had at least 2-3 other students in the same ED pod. This created a sense of competition among the students because they paired 2-3 students to 1 resident. You are already stressed enough because you are auditioning...last thing you want is other students gunning against you. When you rotate at other hospitals, you'll notice that they pair you up 1:1 with attending physicians. This is how you will be evaluated properly, not when you are with other students following the same resident around. Don't get me wrong...most residents were nice people. They also seemed very competent at what they were doing. But the residents were often frustrated because they had to take care of 2-3 med students. I don't blame them because I would be annoyed too if I was in their shoes. Oh, and don't expect to work with the attending physicians too much. There are 2-3 attendings at most who genuinely care about the student's experience... the remaining attendings don't give a flying crap.

Second issue also goes hand in hand with the first. Because there were too many students, it took a LONG time for the PD to write SLOE. Personally, it took them almost 4 months to upload my SLOE. I was literally like WTH?? when they uploaded the letter towards the end of the interview season. You'd be thinking how all this mess can happen in one rotation site, but it ain't over yet. I'm not sure if other schools have a separate evaluation form (not SLOE, but required for every rotation by school) to be submitted...but beware if you do need one. They NEVER submitted my form to school and I was in danger of failing the entire rotation. I wish I can say that I was the only victim, but I know at least 5 other students who's had SLOE and evaluation issues. I'm sure other students who rotated here will at least partially agree with what I said.

I understand that the hospital is doing med students a favor when they allow students to rotate and provide SLOE. But stating that they will, and not abiding by that statement is basically making false promise. For them, we might be "just another med student," but for med students each audition rotation is a big deal that can make or break your future career. I just hope that Newark Beth Israel can think about this one more time before actually ruining anyone's lives.

No difference from 14 years ago, except it was just an LOR, not an SLOE. I had to ask and ask and ask, and it was the weakest, suckiest "good" letter I've ever seen. It was something like, in the letter writer's experience, he didn't directly see me harm a patient - it was THAT bad.

More things change, the more they stay the same!

 

[deleted547339]

Posted anonymously via Google Forms

Program: Newark Beth Israel
Rotation: EM Sub-Internship
SLOE Experience: Sent SLOE Considerably Late

Comments: I didn't see too many "avoid this place like a plague" postings so I'll contribute. I rotated at this place and it was the biggest mistake of my application process.

First of all, the ratio of students to preceptor was out of wack. The student coordinator in charge of accepting students for away rotation was apparently out of office for a long time, so they accepted everyone who requested the rotation. This left the hospital with way more students than they could handle. For every shift, I had at least 2-3 other students in the same ED pod. This created a sense of competition among the students because they paired 2-3 students to 1 resident. You are already stressed enough because you are auditioning...last thing you want is other students gunning against you. When you rotate at other hospitals, you'll notice that they pair you up 1:1 with attending physicians. This is how you will be evaluated properly, not when you are with other students following the same resident around. Don't get me wrong...most residents were nice people. They also seemed very competent at what they were doing. But the residents were often frustrated because they had to take care of 2-3 med students. I don't blame them because I would be annoyed too if I was in their shoes. Oh, and don't expect to work with the attending physicians too much. There are 2-3 attendings at most who genuinely care about the student's experience... the remaining attendings don't give a flying crap.

Second issue also goes hand in hand with the first. Because there were too many students, it took a LONG time for the PD to write SLOE. Personally, it took them almost 4 months to upload my SLOE. I was literally like WTH?? when they uploaded the letter towards the end of the interview season. You'd be thinking how all this mess can happen in one rotation site, but it ain't over yet. I'm not sure if other schools have a separate evaluation form (not SLOE, but required for every rotation by school) to be submitted...but beware if you do need one. They NEVER submitted my form to school and I was in danger of failing the entire rotation. I wish I can say that I was the only victim, but I know at least 5 other students who's had SLOE and evaluation issues. I'm sure other students who rotated here will at least partially agree with what I said.

I understand that the hospital is doing med students a favor when they allow students to rotate and provide SLOE. But stating that they will, and not abiding by that statement is basically making false promise. For them, we might be "just another med student," but for med students each audition rotation is a big deal that can make or break your future career. I just hope that Newark Beth Israel can think about this one more time before actually ruining anyone's lives.

Not trying to belittle a program not fulfilling the obligations, but to say that an audition rotation can make or break your career is a bit dramatic. Try to keep things in perspective.

 

[deleted109597]

Not trying to belittle a program not fulfilling the obligations, but to say that an audition rotation can make or break your career is a bit dramatic. Try to keep things in perspective.

I disagree. I went on an audition rotation at the request of the PD, whom I met at ACEP. I hadn't even considered the program. I went, and did well, according to the PD and quite a few of the other attendings. The aPD that wrote the SLOE, however, thought otherwise, but didn't bother to tell me. And even wrote completely untrue statements about me skipping days of work and the like. I put it as part of my application. Went on 11 interviews. Ranked 11 programs.
I didn't match. My "virtual advisor" didn't tell me about the hand grenade of a SLOE. Nobody at my school would even go so far as to say "use or don't use this". Only a chief resident at another away rotation that I had befriended was willing to let me know what was in it. So the second time around, I didn't use it. Interviewed at 13 that time. Matched #1. If that letter had been there, I probably wouldn't have matched the second time around. There weren't any scramble programs the first year, and not many the second year. So, no, it's not too dramatic.

 

[RustedFox]

Not trying to belittle a program not fulfilling the obligations, but to say that an audition rotation can make or break your career is a bit dramatic. Try to keep things in perspective.

Yeah, I second the opinions of NBEMC from the anonymous poster. I rotated there as a MS3/4, and I had to remind faculty over and over again to "get that LOR (this was before the SLOE) in, please". The bizarre part was that I know it was a good letter, and when I "reminded" the writer (again, before SLOEs, any faculty member could write you a letter) about it he/she seemed like: "Oh, yes! - Your letter! I'll get that done tonight. Remind me tomorrow." Limited idea.

 

[Cinematographer]

I disagree. I went on an audition rotation at the request of the PD, whom I met at ACEP. I hadn't even considered the program. I went, and did well, according to the PD and quite a few of the other attendings. The aPD that wrote the SLOE, however, thought otherwise, but didn't bother to tell me. And even wrote completely untrue statements about me skipping days of work and the like. I put it as part of my application. Went on 11 interviews. Ranked 11 programs.
I didn't match. My "virtual advisor" didn't tell me about the hand grenade of a SLOE. Nobody at my school would even go so far as to say "use or don't use this". Only a chief resident at another away rotation that I had befriended was willing to let me know what was in it. So the second time around, I didn't use it. Interviewed at 13 that time. Matched #1. If that letter had been there, I probably wouldn't have matched the second time around. There weren't any scramble programs the first year, and not many the second year. So, no, it's not too dramatic.

Thank you for sharing this. One of my med school friends who applied for EM ended up SOAPing into an IM program. The red flag on his application? A single negative SLOE. Otherwise his application was probably just as good as mine. He matched, so in this case the undeserved bad SLOE wasn't career-ending, but it could have been.