Yale-New Haven Residency Reviews

[Poncho]

Yale - The evening preceding the interview, the residents took us out for dinner and drinks in New Haven. New Haven itself, despite the bad rap, has some nice areas with lots of good restaurants and cafes, 3-4 solid places to go out (according to the residents), close access to NY and Boston, and access to all the amenities of being at a major ivy league university. The residents seemed to be very friendly and happy at their program. Their only complaints were that some of the didactics, like the resident lectures weren’t the best, and that the residency is still continuing to iron out some issues with respect to the direction of major trauma resuscitations with the surgery department. They currently split time with the surgery department in who runs the trauma, but they manage all the airways. They said this is made up for in with the rotations at Bridgeport hospital, their community affiliate which they said is a gem of the program, There they do everything on their own and it has a high volume of trauma (including penetrating) since it even more inner city the New Haven. The new PD Laura Bontempo is highly respected by the residents and has some new directions for the program with the incorporation of medical simulation into the didactic sessions and applying for more residents to allow residents to have more time learn about their patients since interns typically see 1-2 patients per hour. During the presentations, the directors of EMS, research, ultrasound, Bridgeport, Trauma, critical care, and a chief resident all spoke about their respective areas. The EMS director is nationally recognized leader in the field and there is an EMS fellowship. There are several funded research projects going on in sepsis, substance abuse, EMS, and ultrasound. There is new critical care guy out of the EM/IM program at Henry Ford. The patient population at Yale has a diverse mix of underserved as well as insured patients. The ED facility is a little cramped, but there are plans under way to build a new facility in about 5 years. Interviews took place in the afternoon and consisted of one 10 minute interview with the PD, and 4 20 minute interviews with the other faculty members. This seems like a very solid academic program on the rise.

Beth Israel Deaconess – BID is situated in the Longwood medical campus of Harvard which seems almost like the NIH. It is surrounded by suburban tree lined streets of Brookline on one side and on the other side by Mission Hill a more inner city type neighborhood. The day began with breakfast and lecture by the PD. The lecture reflected all the strengths of the program including the very happy and academically productive and nationally recognized faculty, all the resources of Harvard with very good working relationships with all the other services, flexibility of pursuing academic interests in the junior attending 4th year (with a nice $100,000 salary as opposed to a resident salary), state of the art ED facilities, and the high acuity of patients seen in the main ED. There were 4 20 minute interviews with faculty and the PD, all of which were very informal. There was lunch with residents who were all extremely happy with the program. They definitely do not have the snotty ivy league fell that one might expect, and rather the program seems like it deserves the reputation of being the most west coast program in the east. This is instilled with vision of Carlo Rosen (PD) and Rich Wolfe (Chair) who are out of Denver and created the program from scratch. The only weakness (or plus for some) is the relative lack of underserved patients in the main BID ED as most of them have a PCP. The addition of St. Lukes and Brockton ED rotations in the 3rd year is supposed to make up for this, and according to the residents they do somewhat in terms of the skills needed for penetrating trauma, but this is not a focus of the residency.

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[southerndoc]

Yale-New Haven Emergency Medicine Residency

There are a lot of opportunities available here. Tons of critical care, ultrasound, EMS, international, research, and a lot more.

Ultrasound: By far one of our greater strengths. There is a dedicated month during the PGY-1 year with opportunities for electives during your PGY-3 and -4 years. By the end of your PGY-1 year, you will be comfortable performing almost any type of ultrasound: E-FAST (extended to include pneumothoraces and pleural effusions), right upper quadrant, transabdominal and transvaginal OB, transthoracic echos, aorta (both abdominal and suprasternal), DVT, ultrasound-guided IV's, and more. We have two fellowship-trained ultrasonographers and a very active ultrasound fellowship, so there is a good number of shifts that you will work with one of these guys. All of the attendings are also trained in ultrasound (not fellowship trained) and are capable of supervising you performing ultrasounds in the department. You will usually perform 200 during your PGY-1 rotation, and usually will get 2-5 ultrasounds per shift in the ED. We have a Phillips, BK, and a new GE cart-based machine. The pediatric ED has a Sonosite portable machine. Bridgeport (our community hospital) has a GE cart and GE portable machine. Transvaginal ultrasounds are limited at Yale, but you will do plenty of them at Bridgeport. Bridgeport also has a former Yale resident who completed a fellowship in ED ultrasound.

Critical Care: You will get six blocks of critical care experience, with one block being 28 days (not a calendar month). These include one month each cardiac ICU and medical ICU during your PGY-1 year, a CICU month your second year as a supervising resident, pediatric and surgical ICU during your second year, and a third-year month of MICU as a supervising resident. All of the ICU's are very busy and are demanding rotations, but with excellent teaching. Many of the faculty are well known in their fields. Call is q4 except for the SICU, which is q3 (and allows you to leave at 1 pm pre-call and post-call with rounds beginning at 8 am daily; the post-call team rounds on all patients). Starting your PGY-2 year, you will have dedicated critical care ("major med") shifts in the ED where you will average at least a few intubations and central lines every 3-4 shifts. Probably 15-20% of your patients seen in major med are admitted to an ICU setting, with at least 85% of patients seen in major med being admitted. It's a high acuity area and definitely a learning experience to work there.

EMS: We have several fellowship-trained EMS faculty and an active EMS fellowship. The division chief is well published in pre-hospital medicine, and there are many opportunities to perform research with him. There are also opportunities to take SHARP call (Sponsor Hospital Area Response Physician) as well as getting involved with medical direction of local EMS agencies and the entire system. EMS QA meetings are held monthly and are well attended by the EMS faculty from Yale-New Haven and St Raphael's, the two hospitals that provide medical direction in New Haven County. These meetings are open and any resident is welcome to attend. There is a dedicated month rotation during the PGY-2 year (with a one week flight medicine or QA project requirement), and there is a one week introductory rotation during the PGY-1 year.

International: A lot of opportunities available for international experiences. The most popular is the Yale/Johnson & Johnson Physician Scholars in International Health, which about 5-8 emergency medicine residents participate in annually. This is a funded scholarship that provides up to $5,000 for airfare, housing, meals, etc. to provide international experiences in designated rotation sites. Current sites include Uganda, Zambia, Honduras, Brazil, South Africa, Nepal, Vietnam, Russia, as well as several Indian reservations. One of our residents also is an organizer for a non-profit organization that provides medical relief work to Liberia. Some residents have volunteered time there, either using vacation time or using elective time.

Simulation: This is integrated with the monthly didactic topic as well as individual sessions. Residents are required to attend eight individual sessions per year that present difficult or interesting cases. There are also monthly sessions that are held in conjunction with the monthly didactic topics during our "wrap" session that includes ultrasound, simulation, as well as practice testing for the boards.

Trauma: There are dedicated trauma rotations (PGY-1 at Yale and PGY-3 at Bridgeport), but the real trauma experience comes from the ED. ED PGY-2's manage all "modified" trauma responses during the night, while surgery PGY-2's and -3's manage them during the day. ED seniors (PGY-3/4) manage all "full" trauma responses during the day, while surgery PGY-3's and -4's manage them during the night. ED seniors always manage trauma airways. During the day when the north senior manages the trauma resuscitation, the south critical care/major med resident (almost always an ED PGY-3/4) manages the airway. The airway resident is responsible for completing the E-FAST exam on fulls, and the ED senior and PGY-2 are responsible for completing the E-FAST on modifieds. There is definitely a big trauma experience here! (Usually there are 5-10 modifieds and 3-5 full trauma responses daily.)

Toxicology: At the NYC Poison Control Center. Need I say more? Seriously, this is the busiest poison control center in the country. The residency program pays for your train ticket into NYC (a 70 minute train ride) four days per week during the rotation. In addition to your toxicology month, you'll receive monthly lectures on tox-related topics from one of our three toxicologists. Our toxicologists are operating a consult service within the hospital, which is in its infancy.

Electives: There are six blocks of elective time, with up to four months of away electives possible. Previous electives have included J&J rotations, space medicine at NASA, radiology, ultrasound, pediatric anesthesiology, additional MICU (with no call), ENT/ophthalmology, cruiseship medicine, etc.

Research: The section has a multi-million dollar R01 NIH grant to study alcohol abuse and injury prevention in the department. In addition, there are studies currently evaluating screening for aortic aneurysms, chest pain center patients, biomarkers in head injured patients, etc. I can't even keep up with what's being studied on the ultrasound and EMS side since there are usually many projects going on simultaneously. The department has several research associates. Residents are required to complete original research of publishable quality. This can be in the form of chart reviews, questionnaires, prospective studies, or even placebo-controlled trials. If a resident doesn't want to come up with a project of his or her own, he or she can usually latch onto a project underway by one of the attendings.

ED: I saved the best for last. The ED is definitely the best experience in the program. It is very busy and has a great mix of patients. About 30% of patients are uninsured "clinic" patients, and the remaining are insured. You may go from treating a homeless guy one minute to a Nobel laureate the next. The privately insured patients can be a little time consuming with the need to call their primary care physicians to arrange for follow-up, find out who they wish to use for surgical consultations, etc., but it gives you experience how it will be in the real world. We have a lot of attendings with varying research interests. Almost all attendings love to teach (with exception to two), and the ED senior residents get great experience supervising junior residents. 40% of shifts as a PGY-3 and 60% of shifts as a PGY-4 are spent in a supervisory role. An attending must still see every patient in the department, but the ED senior manages the flow in the department, supervises procedures, etc. in conjunction with the attendings. There is ample attending coverage in the ED, with as many as four adult attendings on duty during peak patient hours and as little as one attending for five hours during the wee hours of the night. For the most part, there are two-three attendings on duty the rest of the time. (This isn't counting the one-two pediatric ED attendings plus a fellow that are in the children's ED.) You do make your own pages for consult services (I find it quicker that way), but for admissions, the information associate automatically pages the admitting team as soon as bed assignment assigns a team. This usually takes 10-20 minutes after an admission request. Boarding is kept to a minimum in the ED, but as the winter approaches, it can get lengthy by our standards (2-6 hours), but may not be lengthy by national standards. The waiting room is usually empty or partially filled since our philosophy is to see patients quickly when they present. You will get ample procedures, and in fact, by the time you're a PGY-3 or -4 you'll be looking for junior residents who want to intubate or do central lines just because you've done so many of them. Only ED residents/attendings and anesthesia (as backup if the ED resident and attending can't get it) can intubate in the ED. We maintain a difficult airway program (with simulation training and a great difficult airway cart) that will let you use Shikane scopes, bougies, intubating LMA's, etc. One of the strengths of the program is interdepartment relations. You will become friends with the medicine and surgery residents during your rotations, and you'll frequently find them at many of our resident parties.

 

[SecretReviewer]

Yale

Locations - Yale-New Haven Hospital, Bridgeport Community Hospital

Space & Systems - Facility is about middle of the road. It’s a little cramped space-wise. There are 2 sides: A/B and C. Most beds are curtains. They have PACS and a few computerized systems (lab retrieval, etc) but almost everything is paper. The paper charts are scanned into the computer for record retrieval.

Peds - mostly at the Children’s ED at Yale-New Haven hospital. There are also some pediatric patients at Bridgeport. I forget how the peds stuff is integrated into the EM months. I think it’s separated out the 1st 2 years then integrated the second 2 years (1 wk in children’s dept for every ED month?). Seems solid but not super strong.

Trauma - there is a lot of trauma in New Haven, 85% blunt and 15% penetrating. There’s also a good amount of trauma at Bridgeport – it’s a community ED but in a bad neighborhood. Yale EM residents are pretty much the only ones in the BP hospital. Traumas are divided with surgery depending on time of day. Major trauma activations are run by EM 7am – 4pm; 4pm-7am is trauma. I was told that residents get way more than the RRC requirements for procedures by the time that they graduate. They also spend some time on the trauma service and in the TICU.

Off Service Rotations - I’m sure you’ll learn all you need to know but I’m not sure how malignant they would be. There are 6 ICU months. There are also 6 elective months (woohoo!).

Ultrasound seems very strong. They’ve got an US attending, an US fellow, and required US experience. Residents are eligible for certification upon graduation.

Residents were some of the smartest I’ve seen. The majority didn’t seem to have much in the way of a sense of humor... take that how you will. The few I met had not ranked Yale #1. This was incredibly disappointing since I otherwise LOVED the program. Possibly I just visited on a bad day? If anybody else had a different experience, please share.

Shifts - 12s early on, 9s weekdays and 12s weekends as an upper level.

Research - seems prolific enough. I think Yale was one of the few places I visited where the notorious "scholarly project" actually has to be research. (I’m not positive that this is the case though, it just seemed that way from the presentation).

Faculty – seemed great. We were introduced to several faculty during the morning presentations and they all seemed really friendly and enthusiastic.

Location - New Haven has a not-great reputation, but there are a lot of cute little restaurants and shopping around Yale. The undergraduate campus is beautiful. The hospital center is only a couple of blocks from campus, so it would be easy to live in this area. The cost of living is pretty sweet for New England, some residents buy homes in the suburbs. It is just under a 3 hour drive to Boston and about an hour train ride to NYC.

Overall -
Pros: Residents seem oober-prepared by the time they're 4th years. Strong research, loved the faculty, 6 elective months including international time, patient population seemed very sick and very diverse, loved the PD, program seemed very well-rounded
Cons: not sure how fondly the EM program is looked upon by the rest of YNHH, New Haven itself might be a con for some. But the only thing that might prevent me from ranking it very highly is that the residents seem to stress themselves out a lot more that most I've met on the trail.

 

[southerndoc]

A while ago I posted a review of the Yale program. At the time I didn't realize the reviews were primarily for medical students to review programs where they interviewed. I removed the review and said I would only post it if I received an overwhelming request to post it.

I am reposting the review after receiving quite a few requests (11 to be exact).

I am a PGY-4 in the program and welcome any additional questions you might have. Feel free to private message me if you have any questions.

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Disclaimer: Posted by a current PGY-4.

Residents: 12 residents taken per year (RRC approved for 13, but no plans to recruit 13 per year at the moment). Residents come from all over the country and have a diverse background. Many have an EMS background. Junior residents work 12-hour shifts (18/month), while senior residents work 9- and 10-hour shifts (17/month). Very few overnight shifts as a PGY-4 (due to necessary PGY-4 trauma coverage during the day). Bridgeport shifts are 10-hour shifts (16-18/month).

Faculty: About 25% of the faculty are former residents of the program. Faculty are primarily from all over the US, with many that are fellowship trained. The pediatric ED is staffed by board-certified pediatric EM attendings. Noteworthy adult faculty mentions are Gail D'Onofrio, the section chief, who has done a tremendous amount of research on drug abuse and injury prevention. Chris Moore, our ultrasound fellowship director, who has a substantial involvement with ultrasound education along with our one other ultrasound-trained attending and two ultrasound fellows. (Ultrasound training at Yale is arguably one of the best in the country.) Dave Cone, the EMS fellowship director, is president of NAEMSP and is actively involved with EMS research. Greg Larkin, who has a ton of research experience and publications. There are three adult and one pediatric toxicology faculty with the program, which creates an excellent opportunity to learn toxicology (despite no toxicology fellowship).

Ancillary Staff: The ancillary staff at YNHH and Bridgeport are superb, and it's unbelievable at YNHCH (I think there are 2 nurses for every 1 patient in the pediatric ED). The nurses are quick to draw labs, start IV's, give medicines, etc. The only time you will be cannulating your own IV's, drawing your own labs, or inserting your own Foley catheters is when the nurse has trouble doing it. Even when a nurse can't get an IV, he or she will usually ask one of the other nurses with more experience to try first before they ask you. For patients with extreme difficulty with access (e.g., sickle cell disease, hemodialysis patients, etc.), we usually end up using the ultrasound to get an ultrasound guided peripheral IV. You won't be transporting patients, but it is hospital policy that we must escort patients to the ICU. Usually when a patient goes to the ICU, the senior resident will walk with the patient to the ICU, and as soon as the patient reaches the ICU doors, he or she will head back to the ED and let the tech and nursing staff finish transferring the patient.

Hospital: Yale New Haven Hospital is the primary teaching hospital. It's a 900-bed tertiary care center with a diverse patient mix. One of the few hospitals where you can treat a Nobel laureate, a prominent politician, a blue collar worker, and a homeless person in the same shift. Many patients have private physicians, so not every admission is a university admission. This gives you experience communicating with private physicians, especially for patients needing follow-up after discharge from the ED. Pediatric exposure is at the Yale New Haven Children's Hospital, where you will spend one month your PGY-2 year as an ED resident and will spend 3-4 shifts/month during your ED rotations as PGY-3 and 4 resident. The community hospital is Bridgeport Hospital, which sees approximately 60,000 patients/year (30% pediatrics). The faculty at Bridgeport are primarily Yale graduates.

Charting: Handwritten Lynx template based charting that is scanned into the computer. It's pretty quick to complete. There is discussion of moving to a complete electronic medical record system, but no firm plans have been announced yet. Medication orders in the ED are written in the Lynx chart, but orders for labs, X-rays, etc. are entered directly into the computer system. Bridgeport utilizes physician computer order entry exclusively. We still utilize the standard grease board to track patients. There is discussion of implementing an electronic patient tracking system, but no definite plans have been created as far as I know.

Curriculum: PGY 1-4. You will spend a great deal of time in the emergency department (total of 27 4-week blocks). The critical care training here is remarkable: 6 blocks total in the CCU (2), MICU (2), SICU (1), and PICU (1). There are 6 blocks of elective time that you can pursue additional critical care training, ultrasound elective, international electives, or just about anything you desire. Previous electives have ranged from international experiences in third-world countries to providing medical care for sailors of the World Cup to performing research on mountain climbers. Core rotations include blocks of internal medicine (1), pediatrics (1), orthopedics/radiology (1), anesthesia/ultrasound (1), OB/gyn (1), trauma surgery (1 intern; 1 PGY-3), and EMS (1) with an optional flight rotation. A one-block experience in toxicology is provided at the New York Poison Control Center (the residency reimburses you for train fares). Simulation medicine is an integral part of the residency program, with requirements for residents to complete a certain number of simulations per year (in addition to those provided during small group learning sessions as part of didactics).

Didactics: Lectures are every Wednesday from 8a-1p (except on interview days, which are 7a-noon). Lectures are usually presented by residents with faculty oversight, but about 40% of lectures are directly from attendings. A lot of guest lecturers are part of the didactic sessions. Many are well known faculty from various Yale departments (cardiology, critical care, etc.). There is a monthly M&M which is presented by the administrative resident (a PGY-4 rotating on an administrative block). M&M is not confrontational and anonymity of persons involved is stressed. The discussions can be very informative. M&M here is meant to be a learning experience and not a scolding for those involved. There is a test at the end of each lecture block that is done the night before and discussed in small group learning sessions at the end of each block. Other small group learning sessions include simulation sessions and a lecture/lab by an attending.

Graduates: A large number (50-60%) choose careers in academic medicine with many pursuing fellowships. Last year, 70% took academic jobs, including Maine Medical, Boston Medical, University of Chicago, SUNY Downstate/King's County, etc. Other notable mentions include the international EM fellowship directors of Harvard/BWH and George Washington.

City: Despite what many may have heard, New Haven is not a bad city. There are plenty of great restaurants, lots of outdoors activities (a 10-mile jogging/cycling trail, Sleeping Giant park, beaches, etc.), and if night life is your thing, then there are plenty of clubs and bars. New York is an hour away and Boston is 90 minutes away. New Haven has a good train station with trains to NYC (Metro North), DC via high-speed train (Amtrak Acela Express), and Boston (Amtrak) as well as anywhere else Amtrak might carry you. The New Haven airport is small and only served by turboprops and regional jets. Bradley (Hartford-Springfield) is only 40 minutes away and has non-stop flights to several major cities. It's very easy to navigate with short security lines.

Benefits: Salaries are excellent for residents. Our PGY-1's start at $48,500. We get around $1,200/year for education reimbursement. ACEP, SAEM, and EMRA memberships are included. An email account is also provided. YNHH offers a 403(b) with 3% match when you contribute 5%. The standard stuff (health, life, and disability insurance) are also included free. White coats and scrubs with free laundering are provided to each resident. PGY-1's receive 3 weeks of vacation, while PGY-2-4 residents receive 4 weeks/year of vacation.

Positives: Residents are given a lot of responsibility in the ED. As PGY-3's and 4's, you pretty much run the ED. An attending must see every patient, but you gain a lot of experience teaching junior residents, managing patient flow in the ED, etc. We have a great deal of attending coverage, which is probably more than most programs. At peak times, we have as many as 4 attendings working (not counting those that are overlapping shifts and about to go home). All trauma airways are the responsibility of the PGY-3 and 4. All modified traumas are run by the ED PGY-2 during the night, and all full traumas are run by the ED PGY-4 during the day. There are a lot of procedures available here: nearly all ICU-bound patients needing central lines get them in the ED, lots of LP's, etc. The ultrasound training here is top notch. Critical care training is also superb, not only from ICU rotations, but also from two ED attendings who have interest in critical care (one ED attending is also a SICU attending for one week each month). There is ample time (24 weeks) to pursue special interests, such as international experience, dedicated flight rotations, etc. Funding for international experiences is available through the Yale/J&J program. Finally, research is an integral part of residency. Residents are required to complete original research for graduation. There is plenty of opportunities available for research. The faculty is heavily involved with research and we have a great deal of funding from NIH and other agencies.

Negatives: The YNHH ED is old, and space is tight. A new ED is in the works, and I just learned that a goal has been set to expand and rennovate the ED starting in August (pending approval by the State of Connecticut). The section is still not a department within the medical school. Although in my three years here I could never tell we weren't a department (we operate autonomously from surgery), some applicants still see it as a drawback. The ED still relies on a grease board and paper charting, which hopefully will change in the next few years. Our medical director is very computer-savvy and is the medical director for eMedicine, so hopefully he will put together a great patient tracking system.

Overall: Excellent program that I think will become one of the top programs in the country as people become more familiar with it and the program graduates more clinicians.

Website: www.em.yale.edu

 

[southerndoc]

Congrats to all the faculty at Yale for being granted departmental status! The Yale Corporation voted unanimously to make EM a department.

The change is effective 1 July. Dr. D'Onofrio, current section chief, will remain as the chair.

A lot of faculty have worked hard for this, and it's certainly been a long time coming.

 

[Punisher]

Here are some quick facts about programs from last year of interviewing. I tried to be non-biased as possible, but sometimes I threw in some subjective comments. Hope this helps.

FYI, some things may have changed at programs so be sure to ask.

Christiana - 3 years, 12 EM residents/year (+3 EM/IM and 2 EM/FM), 9 hr shifts with 1 hr overlap, 40 hr/wk as intern, 1 mo of night shifts with minimal night shifts on other ED months, >110k volume at main hospital with 72 beds, ~200k combined volume, 5 hrs lecture/week, daily morning conference, monthly animal lab, 1 month orientation, dedicated CT and radiology dept, OR in the ER, $200 mil expansion of Wilmington hospital by 2011, EM gets airway AND procedures in trauma, no anesthesia residents to intubate, no ortho/ENT/NS/optho residents either, fellowships in admin/EMS/US, 6 U/S machines with great U/S faculty, $49k as R1, 6 mo of ICU rotations over 1st two years, interns work >1/2 shifts at Wilmington, no floor months, no state sales tax, 30-45 min to Philly, 1 hr to Baltimore, 2 hours to DC/NY, 90 min to Atlantic City, moonlighting available

Hennepin - 3 years, 11 residents (+2 EM/IM)/yr, 9 hr shifts, >100k volume, very little floor months but surgery heavy, 2 mo neurosurgery as R2, believer in "graduated responsibility" (AKA delayed gratification) so that as R1 you don't have many duties but by R3 you are running the dept, "pitboss" as R3 with no note responsibility, free food, 4 stabilization rooms with U/S mounted on each bay, airways only as R3, 12 U/S machines total which are directly linked to PACS, U/S tech hired to teach residents, EM on ALL traumas and surgery as consult, 1 mo community experience, OB/gyn involves inpt and outpt care, EMR (Epic), sim lab integrated into curriculum, great EMS relationship, 1 wk hospital orientation and 2 wk EM orientation, hyperbaric chamber

Brown – 4 years, 12 residents/yr, >100k volume, brand new ED with cath lab, 2 CT scanners, 72 beds with 6 crit care beds, awesome sim lab 1 day/mo, no boarding in the ED (is that possible?), strong peds EM program, large amount of trauma since they are the only show in town from New Haven to Boston, strong U/S program with fellowship available, 4.5 mo electives, trauma surg without scut work, conferences supposed to have more small group discussion this upcoming year, 20-22 shifts/mo, 9 hr shifts with 1 hr overlap, great international EM, 75 full-time facult, $50k salary as intern

Yale – 4 years, 12 residents/yr, 1 full month orientation, stong U/S program, 12 hour shifts, 18-20/mo as intern, 6 mo crticial care over residency, tox month at NYU Bellvue, 2 hours sim lab per month, 6 mo elective time, $51k as intern

USC – 4 years, 17 residents/yr, 12 hour shifts, 20? shift/mo, top-notch U/S program with over 20 machines, 12 resus bays, tons of procedures, EM has ALL hospital codes, work in the underground jail ED, excellent teaching with tons of videos uploaded every month, attendings doen’t write notes so that have more time to teach, observation unit run by attendings and NPs, new hospital with good facilities, no EMR using all paper notes but plans to upgrade

Highland – 4 years, 10 residents/yr, one month EM orientation, awesome U/S training with 2 U/S fellows, county program, great salary, uses EMR, ski cabin in Tahoe that residents share, one month off per year, 3 informal teaching session in the ED per day, free food all the time, no OBS unit so you must admit all low risk chest pain, rotate though many hospitals (Kaiser, UCSF, Children’s, SFGH), ortho rotation includes time in OR, great tox month at SFGH, weaker IM program can be frustrating

Carolinas - 3 years, 14 residents/yr, >100k volume, very nice hospital, only 1 hospital to rotate through, labs results broadcast to free PDA, didactics daily with free lunch and protected on off-service rotations, fellowships in tox/EMS/US/peds/research, large amount of off-service rotations but I was reassured that they are important, $45k/yr as intern, no EMR but orders by computer coming soon, no orientation month, 4.5 resus bays, no direct medical school affiliation, residents go to SAEM 2nd year and ACEP 3rd year

UMass - 3 years, 12 residents/yr, no medicine floor months but lots of ICU, 10 hr shifts, 20-22 shifts/mo, 5 u/s trained attendings and 8 toxicologists, volume 80-90K and growing, 200+ million dollar ED, new CT scanner, located in worcester (pronounced wooster), helicopter medicine - one month in PGY1 with a 2 or 3 running the show (the bird never flies without a resident) but can be grounded often in winter, every U/S is recorded and Q/A'd by U/S doc, likely elimination of PGY3 elective to Hawaii with free housing/car, 45-60 min from boston, plenty of trauma with all procedures/airway being done by EM residents, residents can moonlight in the ICU starting 2nd yr, 5 hours weekly of didactics, computer tracking system with labs/rads results but orders/vitals/nursing notes/MD notes are all paper and then scanned into computer that you can pull up later if needed.

Vanderbilt – 3 years, 12 residents/yr (increased by 1 this year), no floor months, 1 hr lecture each morning by PD or chair of EM, 1 month orientation with reduced ED shifts and great teaching, awesome EMR, >100,000 combined volume of main hospital and children’s, teaching by U/S fellowship trained EM physician, >3k level 1 traumas/yr, video review for each trauma, 2 BS toxicologists, ED radiology 24 hrs/day, emergency cardiologist in ED, 6 wks community ED, moonlighting allowed, 2 CT scanner, 4 active trauma bays, 10 hr shifts as R1, great sim lab with 1 day/mo, Keeping Up! (EBM review website) run by attendings, $49k as R1, fellowships for EMS/international health/peds, no anesthesia residents/attg necessary for PSA, tons of airway devices, evals p every shift/month/6mo, great EMS relationship

 

[buyerbeware]

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[quicknss]

Thank you for your honesty. I know a lot of applicants need this warning since the gold reputation of Yale as an institution is a lot to resist. Although the residents told me they were happy when I interviewed there last year I sensed something amok and chose not to rank yale.

The biggest turn off which I expressed in the survey that was sent out to us asking about our interview experience was that one of the faculty prominent in international medicine argued with me about how taking care of the poor and undeserved was an abomination to emergency medicine. I could never see myself at an institution where faculty were pissed that customers couldn't pay their bills. In fact he continuously referred to patients as ungrateful customers. That's just not my style of medicine. Good luck buyerbeware, hope you make it out alive!

 

[starwarp2k2]

Posting here because I've found prior SDN reviews very helpful.

Pros: Very strong subspecialty presence (you name it, they got it) / tremendous resources. Best benefits I saw on the interview trail ($59k + free health insurance). Sick + underserved population. PD is invested in the residency and has a nontraditional background. Can moonlight.

Cons: FOUR year program, but still only 4 weeks of vacation per year and only 4 total elective blocks. No electives in first or second year. New Haven cost of living is relatively high.

Notes: Missed dinner and so only met 2 residents. Unsure how much Yale reputation really matters when applying for jobs/residencies, but it can't hurt, right?

 

[hoot504]

Posting here because I've found prior SDN reviews very helpful.

Pros: Very strong subspecialty presence (you name it, they got it) / tremendous resources. Best benefits I saw on the interview trail ($59k + free health insurance). Sick + underserved population. PD is invested in the residency and has a nontraditional background. Can moonlight.

Cons: FOUR year program, but still only 4 weeks of vacation per year and only 4 total elective blocks. No electives in first or second year. New Haven cost of living is relatively high.

Notes: Missed dinner and so only met 2 residents. Unsure how much Yale reputation really matters when applying for jobs/residencies, but it can't hurt, right?

I took away the same positives and negatives. On another note, I was wary of this program given some of the statements made on this forum in past years. I didn't detect anything to lend any substance to those claims (see above). Seemed like a strong program with relatively happy residents and faculty.

 

[whoopthereitis]

can anybody post about their experiences recently? (rotators, residents, people interviewing here)

 

[Epinephreus]

Interviewed at this program this cycle, one of my top programs for sure:

Facts (neutral):

• 4 years
• Promotes research (or other scholarly type activities)
• Expected to develop a niche before graduating

Pros:

• Academic institution that serves an underserved community = a true diverse population
• Gorgeous new ED, sim lab.
• Pediatric exposure throughout 4 years ("bolus drip approach")
• Endless opportunities to pursue just about any niche - strong exposure to US, global health, etc.
• Well compensated, low COL in new haven, 4 weeks vacation time (taken out of Bridgeport Months) that is very flexible in how you break the time up
• PD is really dedicated to the program
• The residents all seemed like very normal people who literally raved about the program on the interview day.
• Easy to admit patients (you are given a phone with every number in the hospital on it, so you can communicate easy without playing phone-tag)
• 2 weeks tox in NYC (they pay for train)

Potential Cons:

• Location (I personally love New Haven - offers typical Coastal New England feel with easy escape into NYC on Metro North)
• Didactics are very regimented (you take quizzes weekly on reading). You go through text twice during residency
• 2 months / yr at Bridgeport hospital (about a 25 min commute, need a car) - (Level 2 trauma center, Burn Unit, Peds and Adults) - residents spoke very highly about this experience
• Complicated trauma split with surgery (day vs night IIRC), but residents all see tons of trauma given the area and only level 1 trauma hospital in new haven.

Cons: No real red flags on interview day (although they will address previous things posted on the internet)

Impression: Whatever potential drama that was in the past is in the past. This is a very solid East Coast program that benefits from having a diverse patient population that does not need to be split with other hospitals in the area. Furthermore, You benefit form all the resources of a top academic institution. Lastly, the residents seemed very happy.