[2017-2018] Emergency Medicine Rank Order List Thread

[ScoutQ4]

Hard to rank my list after my #1. What are ya'll prioritizing?

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[AlgernonMed]

Hard to rank my list after my #1. What are ya'll prioritizing?

Sick patients, opportunities for procedures, fit for myself and my family...similar to a lot of what other people have said in their lists

 

[gamerEMdoc]

Hard to rank my list after my #1. What are ya'll prioritizing?

Most of what most people think is important is not, you will find that out no matter where you match. The difference between one more or less floor month, subtle differences in didactics, etc. None of that will make a difference to you one month into your residency. By far and away, fit with in the group, fit with the location for you and your family, and the ability to see a sick patient population where the ED gets to do a lot of procedures would always be my advice to ranking programs. No matter where you go, you'll get decent training. No matter where you go, you'll be extremely in demand and will start getting recruited in your first year of residency for jobs. So you might as well be happy wherever you end up and enjoy where you work and who you work with. Just my two cents, take it for what its worth. It's how I decided on my rank list about 10 years ago.

 

[slatermd]

Most of what most people think is important is not, you will find that out no matter where you match.

This is actually the only point I ever try to make around these parts.

Advice, like youth...usually just wasted on the young.

 

[gamerEMdoc]

So, its like nearly 9pm, the time lists have to be certified. Is it safe to say there will be a windfall of rank list posts on the way?

 

[chosennewton22]

Applicant Summary:
Step 1: 240s, Step 2: 250s
EM rotation grades: HP/HP/HP
Inducted into Alpha Omega Alpha: No
Medical school region: Southeast
Anything else that made you more competitive: Research, volunteer work

Main Considerations in Creating this ROL: Very narrow geographic focus. withdrew from a bunch of places early on after getting interviews in the mid-Atlantic. 3>4


1. Carolinas: (++) Great residents, single site, love Charlotte, longitudinal peds, 10 hour shifts, strong faculty, good path, great benefits, four weeks vacation. (- -) peds floor month intern year


2. Palmetto Health (++) everything. PD was my favorite on the trail and has a clear vision for the program that he has seen into implementation, excellent benefits, high quality residents from all over the place, hours bank is awesome, Hawaii elective third year, focus on business of medicine, one of the best ultrasound programs. This would be my #1 if not for Charlotte>Columbia. (- -) They work some 12s? can’t think of anything else


3. Greenville Health (++) seems like Carolinas-lite and got a very similar vibe from the two hospitals, crazy volume in a beautiful hospital that’s technically community but also acts as safety net, super enthusiastic people, the PD and APD are both awesome, great benefits, Greenville is a fantastic city (- -) still new program, seems to be figuring turf wars out but a few weird things remain like surgery still taking some trauma airways


4. VCU: (++) loved the residents, batched nights (work 2-3 nights/month in normal ED months), 18 10h shifts/block all three years, great PD, beautiful ED, cool toys (TEE), ultrasound heavy, Richmond is awesome, low COL. (- -) medicine wards month, horrible benefits (~$350/mo health insurance for s/o and myself, $50/mo parking, only $100/year for food)


5. UVA: (++) got along well with the residents, really like Charlottesville, faculty seemed high quality, great health insurance (can have a baby for free), liked the PD, academic center so see sick patients (transplant, chemo, etc) (- -) low volume ED, limited job opportunities for spouse, minimal trauma, get shipped out for OB, peds EM months, floor+peds surg month during intern year


6. UNC: (++) Really enjoyed the group of residents, PD is great and seems like she advocates for residents well. Two hospital system is good for different practice settings. Love Wakemed. Peds is strong. (- -) From experience, the commute is pretty terrible as the hospitals are 50 minutes apart and I’d want to live in Raleigh, UNC ED is slow with bad boarding problem and minimal trauma, interns work 12s, bad benefits (pay for parking, expensive health insurance). Intern year would be crappy comparative to other places between the 12s+wrapping up patients+commute


7. MUSC: (++) PD was hilarious, Charleston as a city would be fun. Seems relatively high volume, two EDs about a block apart. Program is coming into its own, adding fellowships and other rotation sites (freestanding, community) (- -) Weak resident turnout for the dinner, didn’t get a great feel for what the other residents are like. Not sure how great the pathology is that they see. Don’t like the fact they only have 6 residents a year and almost all of them rotated there or were MUSC students. Felt inbred.

8. EVMS: (++) liked it way more than I expected and it was the biggest surprise of the trail, great sales pitch with good clinical training at multiple sites, peds is very strong, 8 hour shifts, intern year seems pretty manageable, I liked all of the leadership and the PD was very friendly. (- -) Don’t want to live in Norfolk, traffic is terrible


9. Orlando Health (++) super fun residents and faculty, community/county hybrid feel, strong peds EM with EM faculty running the peds dept, very similar feel to Carolinas and Palmetto and probably my fourth favorite program (- - ) medicine floor month, pay for health insurance, don’t want to live in Florida


10. Virginia Tech Carilion: (++) mountains are pretty, low COL, intriguing PD. (- -) I thought this was a bizarre program. They made a big deal of actively trying to become “the best program in the country” and it seemed like they looked down their nose at anyone who wanted to go practice in the community after training. Quote from the tour guide “If you want to just do the work during residency and go practice in the community, then this isn’t the program for you.” Weird for a fledgling residency located in a community hospital. I hated my interviews here, they were the only ones I had were I didn’t vibe with any of my interviewers and thought the majority of them were standoffish. If not for location this would be my least favorite program


11. ECU: (++) good training, high volume and acuity, lots of peds months with integrated peds shifts, low COL. (- -) weird vibes from the residents, thought the PD was strange and not sure how he would be at advocating for the residents, having lived there Greenville is straight terrible


12. LSU New Orleans (++) great pathology, gun and knife club, beautiful ED, very friendly residents and faculty, the PD is the absolute man (- -) far from family, not really sure what the point of their fourth year is and they didn’t sell it great (“you get to do tons of moonlighting!”)


Invited to Interview, but declined: UF-Gainesville, Mississippi, Louisville, UT Memphis, LSU Shreveport, LSU BR, UT Nashville, Medical College Georgia


Withdrew at the end of October: UT Houston, Baylor, Hopkins, UK, UTSA, USF, Indiana, JPS, Florida Hospital, UT Chattanooga, GW, UF Jacksonville

Rejected: Emory, Maryland, Cincinnati, UT Austin, UAB, Vanderbilt

Silent: Wake, Duke

 

[EM2018orBUST]

Applicant Summary:
Step 1: mid 220s, Step 2: mid 230s
EM rotations: H/H/HP
Inducted into Alpha Omega Alpha: No
Medical school region: Northeast
Anything else that made you more competitive: I assume my letters are pretty good as I’ve gotten very strong evaluations through third year. I also had a decent research resume coming into med school and did some other projects during my preclinical years.

Main Considerations in Creating this ROL: Classic displaced west-coaster looking to match back home so location became my number 1 factor. I also am interested in fellowships and an academic career so I preferred places that gave me more exposure and mentoring towards these paths. I prefer 3>4 but was willing to overlook it, while I highly preferred avoiding 12 hour shifts. During the interview season I also came to realize I liked programs with shifts at different hospital with different patient populations to diversify the educational exposure.



I apologize that this became so long and ramble-y. I wrote this throughout my interview season and I found that it was very cathartic as well as useful for my rank list by allowing me to reflect on what I thought about each program. I definitely recommend people trying something similar for future cycles as it would be a great help for them and as well as for even further cycles of applicants who would have more extensive write-ups on each program.


1. University of California San Francisco – San Francisco General Hospital

Really liked this program for a lot of different reasons. Right in the heart of SF, barring COL (admittedly a very big thing to overlook), has to be amongst the best locations for anyone looking to live in an urban environment. Residents split their training at three different hospitals, Parnassus – which is primarily a tertiary, community based population; SF General – which was originally the city’s county hospital; and Mission Bay – which is a dedicated children’s hospital. The new General hospital was built in 2016 and it is absolutely amazing. Out of all the EDs I saw, this one was probably the nicest one I saw, definitely in the top 2 or 3. Patients have individual rooms the size of ICU suites and the entire layout feels very open and sleek. It’s named after Zuckerberg, who funded the new building, which is a little weird but I suppose he’s not necessarily the worst person it could have been named after. It does fit the SF tech image as well.

As the only trauma center in the entire city, SF General sees a deceptively high amount of trauma and is the safety net for the innumerable indigent population who often have severe pathology. The academic aspect of UCSF can’t be overstated but it also offers a much more solid county experience than would be expected. Combined with cadaver sims, most interns had finished most of their procedures by the first year. Due to these sites, UCSF can be considered a solid blend of county, community, and academic. Residents seemed very happy and are close even outside the hospital, are on first-name basis with attendings, and I felt that I had a good connection with them. The residents stated that teaching on shifts was very good and all the attendings were enthusiastic about resident education. The program also has mini-fellowship tracts called Areas of Distinction which provided small groups and faculty mentoring which is great if you are interested in side academic pursuits. As someone interested in academics and fellowships, this is a perfect arrangement of opportunity and mentors to further that pathway.

Cons: Two big negatives, COL and newness of the program. Housing prices in SF are absurd, though the program offers 12k/year in location stipend which is really generous, offsetting what is amongst the lower salaries of the all the places I interviewed at. Almost certainly you are going to be living with roommates in a cramped apartment. Also, the residency is only 10 years old so it’s still in the process of carving out its role in a powerhouse hospital system. Whereas in other hospitals EM is by far the dominant residency, that is very much not the case here. Though the residents did mention that they have very good relationships with other services and don’t have conflicts with admissions/consults. They still are not 100% responsible for trauma airways as anesthesia is in charge of higher level traumas. The EMR at General is also apparently terrible, while they use EPIC at the other hospitals. This is also a 4-year program, which is unfortunate, especially since you’d probably be considering fellowships if you choose to go here.

Comments: Only other thing I would mention is that while SF is a cool city, it’s not for everyone. It’s a big plus for me, but could be a negative for a lot of other people. This also applies to NYC which is where a lot of my other programs are. They are both very populous cities which means that there are a lot of people that must like living there, but you do need to be sure that you’ll be the type of person that likes living there. SF has fairly bad public transportation given how difficult having a car is. Homelessness is also a big deal so small crime is a problem; apparently if you ever leave a bike outside it will definitely be stolen. You also literally walk over people sleeping on the streets in the area around the hospital. There are certainly a lot of positives to the city, but I’m just clarifying that just because I think that being in SF is a huge plus, I can easily see how many other people would hate it.

For me, this was the easy #1 as it is a well-regarded program in a city I would love to live in, incredibly strong faculty and research/fellowship opportunities matching my own specific interests, high emphasis on teaching, residents I got along well with, among the nicest hospitals, and in general was the place I felt like I wanted to be most. I’m still not super happy about it being 4 years, on top of the fact that I think I want to do a fellowship afterwards, but the rest of the program seems like such a great fit that another year of destitute poverty seems bearable.

2. University of California Davis

Somewhat of a low key program but definitely has its strengths. A very well-known and respected program for both clinical and academics with alumni all over. Residents here were really open and easy to get along with and seemed to really like the program as well as the faculty. The PD didn’t interview us, but spent the entire interview portion of the day in the waiting room with the applicants just chilling and conversing with us. He was very personable and approachable, though I do admit it would have been nice to have the opportunity to have more serious discussion with him about the stereotypical residency topics.

Clinical training is certainly solid with residents spending time at both the university hospital and at Kaiser. The main hospital was the previous county hospital of the region (Sacramento County Hospital) and still serves a similar role in the area. Spending a good amount of shifts at Kaiser is great networking for those looking to go straight to a community job. The hospital is located in Sacramento, which is much more urban and livable than the city of Davis as the name implies. Sacramento has the feel of a large city but isn’t crowded and you can actually drive around downtown. COL is reasonable, especially if you are willing to commute and it’s a very bike-able city with (we were told) great restaurants. You’ll still hit farmland once you’re outside the city, which apparently is what allows the city to call themselves the “Farm to Fork” capital.

This year, the residency program is partnering with the Air Force to provide 5 additional residency spots per class, raising the class size from 15 to 20. It wasn’t too clear how this would change the program but faculty were fairly confident there wouldn’t be any effect for the regular residents other than having a bigger class. About 25% of the graduating classes go onto fellowships, which is a bit lower than some other academic programs, and I think more a reflection of the type of people coming here than an inability to get positions. The emphasis on community medicine and the location in a more rural-ish place probably lends itself more towards community type residents.

Cons: Felt that the trauma load was lower than some other programs and while Sacramento seemed good, after you leave the city, it’s all farmland until you hit SF. During the tour, the physician work areas seemed smaller, and the entire ED had a dull lighting which made it feel a lot more claustrophobic. Residents didn’t seem to like conferences though I don’t remember why, just have that jotted down in my notes.

Comments: Very strong program with excellent clinical and academic exposure. Felt like a very good fit as well, but just wasn’t quite as fitting as UCSF. COL is so much better here though, so my wallet and bank account may be happier about me matching here 5 years down the line if things go down that road.

3. University of California Irvine Medical Center

Came in thinking I wouldn’t like this program as much due to the much smaller patient load and bougie location. They do a good job selling the fact that they have a much smaller residency class so each resident is responsible for much more patients than they would be at other programs with much busier EDs. Some other reviews of the program seem to agree that residents here are busy. Some interviewees who had rotated here additionally confirmed that the residents were always pretty busy, so I was willing to buy that argument. Also, despite being located in Orange County and literally down the road from Disneyland, they have a good mix of acuity and trauma. They have an elective rotation at a community hospital on Catalina Island which sounds pretty interesting as you have to balance out medical concerns with the necessity of airlifting or boating out patients you want to admit to the mainland.

Of course UCI is known for being a powerhouse of ultrasound research and they had an absurd number of them in their ED compared to everywhere else I’ve rotated. Research would definitely be a strength and emphasis here, regardless of whether you wanted to do it in ultrasound or not. They also offer faculty mentoring for people who have identified areas of interest, but there is no formal system. Conferences seem more interesting as they try to do more interactive lessons than straight lectures. The day of my interview, they were doing a jeopardy-style competition. Lastly, the hospital is gorgeous; it felt like I was pulling up to a hotel as I was driving around the outside on a nice sunny day in what would otherwise be winter. The surrounding area is likewise really nice and there are relatively cheaper places to live within a reasonable commuting distance.

Cons: It’s a smaller residency class so it’s harder to get to know your fellow classmates and it seemed like they weren’t quite as close as other programs were. Residents said that you tend to know the residents in other classes better than your own because you work with them more often. I also am not sure I believe how good their acuity and trauma is, especially if you compare it to much more urban programs. They also rotate at 5 different hospitals in the Orange County region, though some of them look like they’re about an hour drive away from the main hospital. Compared to other 8-10 hour programs, UCI does slightly more shifts (20/20/17) which could help determine a tiebreaker for some.

Not a con, but despite the fact that peds rotations were at CHOC, the residents didn’t seem to think that it was a big plus to the program. So anyone who assumes the peds experience here is going to be one of the best just because of the big name children’s hospital should do a little more research into it. It’s not a priority for me so I dropped my inquiry once I realized the residents weren’t as excited about it as I thought they would be.

Comments: This program started much lower on my initial pre-interview list but greatly crept up after coming here. I really liked the feel of the residency program and the faculty here, just feel that the clinical experience here may not be quite as good due to the patient population and high socioeconomic location. I really wanted to bump this up to #2 because I like the location much more than Sacramento, but I really felt the clinical experience at Davis was better so I couldn’t justify the swap.

4. Loma Linda University School of Medicine

Every review you read about Loma Linda mentions the strength of the peds experience and they certainly hype it up in their presentation. A part of me wonders if it’s still as far ahead of other programs as it used to be, seeing as how integrated peds shifts are now the standard at other places. But all the faculty and the residents did state that they felt very well prepared to handle kids so there’s probably still something to the claim. They have a large catchment area, though it’s relevant to note that UCR just started their residency program and is located just 10 miles away. My interviewers didn’t seem concerned by this and didn’t think that there would be any change in the LLEM experience. Residents rotate at both Loma Linda University Medical Center and Riverside County (not associated with the other Riverside residency). Residents described being very independent during their county shifts and having much more responsibility, partially due to the attendings there being much more hands off. There is a good amount of rural medical problems such as snakebites, drug use at raves, etc. It’s worth noting that I felt the most comfortable with the residents here – not that I didn’t get along with residents at other programs, but the ones here felt the most like people I’m already friends with.

Everyone knows about the Seventh Day Adventist aspect of the hospital and the caffeine/meat ban but it is a little overstated. While undergrad and medical students are expected to refrain from tobacco/alcohol/drugs, my impression is that none of this applies at the residency level. The cafeteria does not serve coffee or meat, but you are free to bring it in yourself. There is a vending machine in the ED that has energy drinks, and there’s a Keurig in the staff room. The residency programs themselves seem very detached from the religious affiliation and the only difference you would see is Bible verses on the walls. I personally don’t drink coffee and hopefully won’t be eating at the cafeteria too often so I don’t care much about this aspect.

Cons: San Bernardino is pretty out of the way. When a program cites being close to a bunch of major cities as a positive (Los Angeles, San Diego, Las Vegas), that’s usually a sign that the area itself isn’t that great. However, the area itself isn’t terrible and definitely closer to Los Angeles than other places. If coffee is a necessity, you can bring your own in a thermos, but it won’t be available in the cafeteria in a pinch. The religious affiliation, though probably not a huge deal for the residency, does still exist and some might see this as a yellow or red flag.

Comments: I’m not thrilled with the location, but I do think the program is solid and the residency class is one that I would gel well with. It is still driving distance away from some family and friends so it still feels like it’s in a reasonable area for me. The name brand here is weaker than other programs at this place on my list, but as I’d be looking to stay in the region regardless, I don’t think it’s a huge concern.

5. Maricopa Medical Center

I highly regret having to rank so low because I felt it was absolutely amazing and their PD has a huge passion for resident education. There are a lot of really cool things going on with their clinical exposure as the PD is dedicated to constantly changing things around and optimizing the experience while still making space for electives and allowing residents the opportunity to pursue more advanced careers despite being at a 3 year county program. He’s a little quirky but in a fun way and he definitely cares a lot about the resident experience. The burn ICU rotation seemed incredible in terms of the severity of patient conditions and the responsibility residents have to take on there. The residents told us stories of all the crazy things that happen there and the extreme levels of acuity that can come in at any time. As a county hospital, the other services a bit weaker meaning EM runs the show here even on many of the off-service rotations. This can be a good and a bad thing as your MICU and trauma senior will actually be an EM senior resident but it does mean the classic didactic learning might not be as good. They also get 3 blocks(!!) of electives which is an insane amount for a 3-year program. As a result, though this is a 3-year county program, residents have gone on to some pretty great places in fellowship and other research opportunities. The residents here seemed to be the closest and have the most fun outside of the hospital of any program I was at. Copa Pride is absolutely a thing and very apparent in all the resident interactions. They had pictures from a bunch of group trips to whitewater rafting, annual reimbursed conference trips, and overall seemed pretty happy. They also block together an entire month of overnight shifts with all golden weekends, which allows for minimal overnights during the normal ED blocks.

As a side note, they are partnering with Creighton University and Dignity Health St Hospital, effective this year. This was sold to us as a means of acquiring a university affiliation and provide support for research. None of the hospitals have an EM program, so there won’t be any new residents added by a merger and there won’t be any changes in faculty. I don’t know what effects this will actually have on the residency education but with some time to think about it, it seems pretty minor. The biggest potential downside to me would be if the hospital had to change its name to Creighton which no one had asked about so I don’t know if that’s already been decided one way or the other.

Cons: Phoenix is hit or miss from what I could tell and based on the experiences of friends who have lived in the area. The city is much smaller than I thought it would be and the thought of summers nearing 120 degrees is terrifying. As you might expect, the patient population is hugely Spanish-speaking, and though there are in-person translators available, as a non-Spanish speaking person, while I would love the opportunity to learn, I don’t like the thought of drowning myself in it. A lot of the off-service rotations are at different hospitals, requiring commuting, though driving in Phoenix is pretty low stress. They also had plans to change the format of their conferences because they didn’t like them very much, but this change was planned for April.

Comments: This is the first program I had to bump down because of location as I strongly want to match in California. If location were not a factor, it would be a strong contender for my top 1. The fact that it’s still on the west coast and no snow made it very easy to rank here right at the border of my west coast and east coast programs.

6. Maimonides Medical Center

A solid, well-known program in western Brooklyn. They are notable for the diversity of their patients as they are situated at the intersection of numerous ethnic communities (ex. Asian, Hispanic, Caribbean, African, Russian, Greek, Jewish). They also have a very strong pediatric experience as they are both a pediatric trauma center and see many sick kids. They are the only pediatric trauma center in Brooklyn, though some brief research shows that other facilities seem to frequently gain and lose accreditation so it just so happens they are the only one during this application cycle. Needless to say, the diversity of pathology and patient population here is probably amongst the best around. The ED also immediately sends patients to a bed to wait rather than sit outside in the waiting room, so they are absolutely swamped with beds inside. It’s pretty overwhelming to see patients literally double and triple stacked but I’d imagine you could get used to anything in time. Residents work a combination of 8-12 hour shifts which averages out to 45-50 hours/week. This is a nice contrast to the solely 12 hour shifts that the majority of other NYC programs work.

Another aspect they pushed heavily during the interview day was the event medicine moonlighting available. Residents cover events at Madison Square Garden and Yankee Stadium. From how they described it, the job is pretty low stress and you end up being able to watch the game or concert for most of the event. They also travel for various music festivals so if that’s something you’re into, the opportunity is abundantly available. The current PD seems to love covering music events so that’s the reason for the current emphasis on this.

Residents can get housing that is down the street from the hospital, and it is much cheaper than equivalent apartments elsewhere in Brooklyn. From pictures residents showed, they were really nice and much cheaper than market price. The residents seemed pretty low key and easy to get along with.

Cons: Compared to other similar programs in the area, it probably doesn’t see quite as much adult trauma. The reputation is not quite as well-known as a household name like Sinai or NYU. And while the diversity of patients is a plus, it also means you’ll have to use a translator phone for a huge proportion of your shifts. A resident said they once went an entire shift without an English-speaking patient.

Comments: The combination of an extremely diverse patient population, strong clinical exposure without the program trying to kill its residents, and lots of event medicine opportunities made this a big standout for me. I’m a big fan of the culture of NYC so with all my NY programs, I tried to emphasis living closer to the fun parts of the city as a tie breaker.

As I alluded to earlier, NYC is a great city but not for everyone. It’s a very polarizing place – you’ll either love it or hate it. I can certainly understand someone deciding they never want to live there while others may see it as their dream destination. So for anyone deciding on a NYC program but have never been to the city before, I’d highly recommend spending a day just wandering around, using the subway and taking a look at the grocers and restaurants. It’s really unlike any other place in the US. For people who have never lived there or worked at any NYC hospital, there are some factors which will be common to all programs in the city: high COL, small apartments, dirty and crowded neighborhoods, tougher work-life balance, NYC nurses. If you were not aware, there is a very strong nursing union in NYC which means, for lack of a more PC way to phrase it, they do less work. Residents are responsible for putting in their own IVs, draw labs, and may even have to push their patients to radiology. Each hospital is on a spectrum in terms of how bad this is, but it definitely exists in every NYC program. You could see this as a plus as you’ll graduate from residency being very confident putting in lines, but I can imagine it gets old a few years in.

 

[EM2018orBUST]

7. Hofstra Northwell SOM at North Shore / LIJ

The current Hofstra residency is the combination of two EM residencies (North Shore and Long Island Jewish), with this being the second year of integration. NS was a 3-year program while LIJ was a 4-year, with the current combined program being a 3-year. It seemed like there were some hiccups and logistical kinks to work out the first year but the residents felt like these problems have mostly been smoothed over. There are still some lingering signs of the merger, for example the prior PDs of each program were retained on faculty and serve in what is essentially an APD position under the ‘super’ PD, but still retain a title without the word ‘assistant’. The older residents are still somewhat divided into NS and LIJ residents, and it seems like the current PGY3 class of LIJ residents will still have to do a fourth year. Weekly conferences are also hosted at each hospital on alternating weeks, though they are only 10 minutes apart by car so it’s not a hassle to attend them. I don’t know if there would be any residual friction from the merger that would affect my residency, but the residents and faculty all seemed pretty happy and enthusiastic so I don’t think it’s much of a big deal now.

The best description of the residency program is ‘bountiful’. Putting aside the salary (btw highest in the nation at 71k PGY1), the program has a lot of money resulting in them having a separate sim building (which unfortunately we were unable to tour but apparently is really nice), fresh cadaver sims, discounted resident housing on campus, and fairly nice facilities (the EDs look a little dated but the rest of the hospital looks great). Also, due to having access to both hospitals, the off-service rotations are arranged to choose the best educational experience of the two choices, resulting in a superior training than either program had alone. Though the hospitals are located in essentially the same neighborhood, they serve very different patient populations. NS sees a much higher socioeconomic, suburban population from Long Island while LIJ sees mainly uninsured and underserved patients from the Queens/NYC regions, allowing residents to practice in both types of environments. They do still rotate for a month at Shock Trauma so I’d imagine that means the main sites don’t see much trauma, and that would be expected for Long Island.

The last interesting note about Hofstra and last residual sign of the merger of two different education system is their “3+1” track. It was a little confusing at first but as far as I understand it, they offer mini-fellowship tracks during the normal 3-year curriculum then at the end of the 3-year residency, you have the option of staying for an additional 4th year but it may or may not be an accredited fellowship. It didn’t make sense to me and it seems like you’d be better served just doing a real fellowship, so this may be an afterthought that will be better defined in the coming years as subsequent classes all choose to not take the extra year.

Cons: While close to NYC, it still isn’t quite in an urban setting and the level of trauma they see reflects that. Residents do rotate at Shock Trauma for a month but I think it’s important to have the possibility of a severe trauma coming in at any time during your normal rotations. As mentioned earlier, there seems to be some residual logistical questions from the merger, so while it isn’t the same as a completely new program, you may run into similar issues as they continue to optimize their program. The residents mentioned that rotating at two different hospitals makes it difficult to form relationships with the ancillary staff as quickly.

Comments: My rank list up to this point was very easy to create and I never had any headaches about how to rank my 1-6. #7 was where I first began to constantly switch things back and forth and debate each program. My dilemma was what order I wanted to put Hofstra and Downstate as each had very different strengths. I’ll discuss what made me put Downstate further down in its own section but Hofstra felt like a good mix of academic, patient diversity, and wellness. Though this program is on Long Island, I didn’t mind the location as it has easy access to Queens and other large population centers in western Long Island.

8. SUNY Downstate/Kings County Hospital

This was the most difficult program for me to rank as it has very prominent strengths and weaknesses so it’s difficult to really pin down how I feel about it. First with the advantages: Kings County is a very busy ED with a lot of trauma and pretty severe pathology. There is a large Caribbean population and at times patients will fly from the island to NYC and come straight to the ED with medical issues that have never been addressed by another medical professional in decades. Residents have a lot of autonomy and come out of their 4th year very well trained. While a heavy county program, many of the residents also go onto fellowships. As one of the largest residency program in the country (this year they are the largest), they have a correspondingly large alumni network. I noticed that a lot of the faculty at other NYC programs trained at Downstate. The APDs I talked to mentioned that they specifically look for applicants who have strong passions in extracurricular interests so that they can balance out their country environment with academic achievements.

The hospital is located a little south of Downtown, so it’s pretty close to the major parts of the borough. The residents seemed to like each other and regularly have class hangouts after conferences. During the dinner, they were all really fun and it was definitely a good time. As I noted before, a lot of their residents go onto fellowships and leadership positions in other programs so it seems like they do a good job training leaders here. And they certainly are well known for their level of trauma so you certainly would come out well trained and ready and handle anything. And though it is a county program in an inner-city type area, there is a stronger emphasis on academics than you would expect. They offer mini-fellowships mentored by various faculty members to help residents explore areas of interest beyond clinical skills.

Cons: A 4-year county program in NYC where they do all 12 hour shifts for the first two years is pretty rough. Once you get to your third year, you start mixing in 8 hour shifts, but you have to get through the first half of residency first. Compared to other residencies, the residents do a lot more of the scutwork which would be a drag given they have to see so many patients. They have a reputation of being one of the more hard worked residencies. Despite this, they seemed to not have a huge focus on resident wellness during the presentation, though that doesn’t necessarily mean they don’t have it at all.

Comments: All in all, a lot of good things here, but ultimately didn’t feel like a great fit. The residents felt more on the bro-y side which I would be fine with but isn’t a natural match with me. Though given how big the residency is, there probably is some group of people that you can get along with regardless of personality. I was ultimately turned off by the 4 years, heavy shift schedule, and my overall gut feeling that I wouldn’t enjoy it as much as other places. I still ranked it higher than other programs due to the strength of the clinical experience and the reputation, but being a 4 year really hurt its placement for me.

9. Hofstra Northwell School of Medicine at Staten Island University Hospital

A newer residency started in the last 10 years, Staten Island and LIJ are associated with Hofstra University, but Staten Island’s relationship seems currently to only be by name. While LIJ is near the Hofstra medical school and is one their main rotation sites, Staten Island is pretty much a standalone institution but they do get the benefit of the Northshore salary. I didn’t get the sense that there was as strong of an academic/research backing though the PD seemed to indicate he hoped that the Hofstra support would eventually boost this aspect of the program. The PD was really enthusiastic and seemed to really care about developing the program and educating the residents. As for the residents, they seemed to get along well and really liked the program. The vast majority of them lived in Staten Island as commuting from the other boroughs is a hassle. If you’ve never been to Staten Island, be aware that it is COMPLETELY different from the rest of NYC. SI is very suburban and more car reliant with no subways. A lot of the residents lived nearby so they could walk or bike to the hospital. Staten Island is also heavily Republican in contrast to the rest of the deeply blue NYC. Not that politics should be a reason to choose a residency, but that’s just another aspect that highlights how different it is from every other borough.

The program itself is really solid, and I think I’ve seen it posted elsewhere on SDN as a hidden gem and I would agree with that sentiment. The faculty is very invested in the residents and as a newer program, they are very willing to change things up based on residents’ feedback. They rotate at two different hospitals (btw there are only three hospitals total on the island), one of which is the trauma center and the other a tertiary community setting. We only toured the main trauma center hospital, which has a large and clean ED, which is a big deal as EDs in NYC are generally crap holes. There’s also an absolutely gorgeous new administration section where they have their sim labs and do their conferences. Though the population and density of Staten Island is much lower than the other boroughs, there are only two trauma centers on the entire island and of those two only this one has a residency program. As a result, the residents I spoke with said that they get a reasonable trauma exposure and had done a good amount of procedures by this point in the year.

Cons: As a newer program, it doesn’t have quite the name recognition of other places. Also, living on Staten Island is much different than living in the rest of NYC. Personally I felt it was not as interesting or convenient as western Long Island. They also work 12 hour shifts with smaller class sizes, making me think you wouldn’t know your fellow residents as well. There isn’t much established academics though hopefully they’ll get there in the near future.

Comments: Though I did think this program had a lot of strengths and would provide a solid education, what turned me off was the lack of reputation and being located on Staten Island. As there isn’t a train to get to the rest of the city, it seems like you’d always be faced with the irony of actually living in NYC while still being so inconveniently separated from all the fun parts of the city.

10. Kern Medical

This was a program that was artificially held up much higher on my rank list for quite a while solely because it is located in California. There were a lot of things about it that didn’t match what I was looking for, so over time it has steadily dropped. That being said, positives of the program are a large catchment area comprising most of the Central Valley, significant trauma load, resident independence, COL, and high acuity.

Bakersfield is pretty infamous in California for being in the middle of nowhere and while this is fairly accurate, this also means that there aren’t competing trauma centers. There are a good amount of rural-type injuries and pathology which come into the ED and not many competing residencies in the hospital so the ED gets to manage a lot of the patient care. The hospital is only a level 2 trauma center, but I’ve been reasonably convinced that this isn’t a big deal for the EM experience, especially if there aren’t any other options in the area. They have an affiliation with UCLA, but I wasn’t sure if this changed anything for the residents as they are too far away to be able to take advantage of any of the university’s resources. Cost of living is very cheap though it’s probably a bit more expensive than an equivalent type of location in the Midwest. Everything is a little more expensive in California, even if it’s in the middle of nowhere. It was pretty obvious talking to the residents that they didn’t love living in the area even if some of them didn’t explicitly say it out loud.

The program itself sees a lot of pathology and high acuity on account of the rural catchment area. It seems like the residents have a lot of responsibilities and there are a lot of procedures to go around. There are very few other services or consultants available, so the ED has to be responsible for much more of the patient care than they would at a more resource-heavy academic center. Though the ED only sees 50k patients a year, they also only have 24 residents, so similarly to UCI, the division of work still ends up with a high number of patients per resident. I don’t doubt that residents from this program end up very competent and having seen a good mix of acuity and pathology. They stated that residents didn’t have much problems getting into fellowships, though most graduates do choose community.

Something I observed during my interview day is that everyone in the program is strongly focused on moonlighting. Both residents and faculty put a lot of emphasis on moonlighting when at most other programs, it was only given a yes/no answer if someone asked about its availability. Even the PD moonlighted at locums and talked about it during his presentation. I don’t think there’s anything intrinsically wrong with this interest, but it came off very weird to me especially as I hadn’t seen anything like it anywhere else.

Cons: Most notably, it is a 4-year program in a very undesirable location. While I would be willing to go to a 4-year program I otherwise loved, going to a city I don’t want to be in for that long is a pretty hard no. While it is still on the west coast and in California, it’s hard to really describe how out of the way it actually is (yes a two hour drive is out of the way for me). I would be much, much happier in a larger city regardless of where it is in the US. And while there is an association with UCLA, I feel like the degree of academic support would be minimal which does not line up with my career goals. Salary is also the lowest of any other program I interviewed at (47k) which admittedly, isn’t quite as terrible given the COL, but at a certain level I feel like there’s a degree of respect shown in how much of that sweet, sweet GME funding the hospital is willing to allot to its residents.

Comments: As mentioned, the biggest draw for me was technically being located in California. Compared to Staten Island, the 3 vs 4 year was a tiebreaker that led me to lower my ranking for Kern from 9 to 10. Even though I’m sure that the clinical exposure here is great, I really just wasn’t feeling it for this place. I realize there might be a disconnect with how highly I rate Loma Linda and how low I rate Kern despite both being in less desirable parts of California, and it comes down to me liking the feel of Loma Linda’s program much better, 3 vs 4, academics, and Bakersfield being much worse to me than San Bernardino. Looking back, the most difficult part of my rank list was how far I wanted to keep dropping Kern due to my initial west coast bias.

11. State University of New York – Stony Brook

I wasn’t sure what to expect of this program coming here as there’s not a lot of info on the place. The program is certainly noteworthy for some high-profile faculty and they push that aspect quite heavily during the presentation. It felt a little heavy-handed to me as it felt like they were hanging their hat on a very narrow aspect of their program, but it definitely is intriguing to have the opportunity to work closely with big names in the field and the residents emphasized the benefits to working alongside such faculty on their shifts. The ED itself is huge and much nicer than any of the other New York facilities I toured. The city itself is pretty far into Long Island (it took me over an hour to get there from NYC), so it’s incredibly suburban which is strongly reflected in the patient population. The program is expanding residency spots and will be fully expanded after next year, which has allowed them to shorten shift lengths, which are now a combination of 9s and 12s. Residents seemed pretty chill and happy. Per them, they don’t suffer from nursing issues and a lot of the other NYC stereotypes don’t apply. COL is also seems more manageable than NYC and you’d be able to live in a house or larger apartment compared to the shoeboxes you’d have to settle for in the city. You may still need roommates though so it’s not dirt cheap. On top of the 55k salary, they also provide 5.5k in additional stipends which I’d imagine would help a lot with housing.

This program didn’t do a typical pre-interview dinner but instead held a single weekly dinner at Dave and Busters for all the applicants that week and then used the lunch during interview day as the resident-only conversation time. It was definitely the most fun ‘pre-interview’ event though it’s hard not to be when you’ve got unlimited free arcade games for the night.

Cons: Location for two different reasons – 1. Long Island is very aptly named, as it is really LONG. It’s so far from NYC that it’s unrealistic to expect that you can casually travel there often. You could probably live in-between to cut the commute but you wouldn’t want to make your work commute too long either. The area around the hospital seemed pretty sparsely populated and not as interesting as a bigger city. Some of my fellow interviewees mentioned how much they loved the area, most of whom were from more rural regions, so your mileage may vary on this point; 2. The patient population is very suburban and I wouldn’t expect you would see much of a trauma load. They do rotate at Shock Trauma for a month, but I think it would be nice to be at a program where you could expect to see trauma on any shift. As far as I have it in my notes, they also have graduated responsibilities, which I’m not sure if I myself, consider a plus or a minus yet.

Comments: Overall, this was a program that I was much more impressed with than I was expecting. I imagine that the reason it doesn’t have as notable of a reputation is for the same reason I’m ranking it so lowly, namely where it’s located. If it was located anywhere in an area that I wanted to live and with a correspondingly less suburban patient population, I’d have to give them a much harder look in terms of how to rank them. The program itself is strong enough and has at least established a name in the EM world that I still rank it above the next places. My last great debate of my rank list was whether I wanted to switch Stony Brook with Kern. Though SB is a 3 year, location seemed out of the way enough that I was now okay going to Bakersfield for 4 years.

12. Brookdale University Hospital and Medical Center

This is a new program, started 2 years ago so this incoming class will be the first time all three years are filled. There’s very little information available about this program, due to their website being a very low priority, so I will expand a bit more about mundane details as I’m aware this may be one of the only sources of information available about them for a while.

The program was started in 2016 as a 3-year program in eastern Brooklyn at Brookdale Hospital, which was used as a trauma rotation site for a few other NYC residencies. The founding PD (aka the infamous PD of last year's rank list thread) left in November 2017 with the interim chair Dr Borenstein stepping in as the new PD. Borenstein has a lot of prior experience starting new residencies throughout the country and this seems to be his new project. The replacement chair is a current PD at another NYC program who will be transferring over. I don’t recall exactly who it was so I don’t want to be more specific than that in order to not spread any misinformation. The original PD was the former PD at Maimonides so when he came over, a bunch of the younger attendings came over with him while the older faculty at Brookdale were cleared out in order to make room. There isn’t a list of who the residents are but my impression was that a large proportion of them were from Caribbean schools.

The curriculum is pretty standard, since the people designing it have had a lot of experience with other programs, with most of the off service occurring in house. Peds ED is done at Maimonides due to the better pathology, and once a month conference is conducted jointly at Maimonides during their peds conference. They have a 4 weeks international rotation during pgy3 but as they haven’t had a third year class yet, there weren’t many details on where they had contacts. Otherwise, residents have expressed that they see a lot of trauma (as indicated by the fact that other programs came here for trauma rotations) and as there are no midlevels, each resident is responsible for a large patient load. Particularly in the first years, residents were probably overworked, but even now with a full cohort, you will probably have to work really hard here. Shifts are 12 hours, with 18/17/16 shifts in each year. Residents stressed that they generally left on time as the last hour was usually spent finishing up notes and not taking on new patients. They are considering changing to shorter shifts in the future once they have filled all their residency spots, but no definitive plans as of yet.

The area is a bit more residential than the rest of Brooklyn however there isn’t a nearby subway stop so many residents do commute by car. There are buses and apparently the program may cover taxis from the subway but I didn’t ask about this. The ED does see a lot of penetrating trauma so that’s probably a reflection on how the surrounding area is. Salary is approximately 58k PGY1, 4wk vacation.

Comments: Overall, I was much more impressed with the program than I was expecting to be. The hospital certainly has a very impressive patient load (100k for 24 residents) with a patient population that has a large amount of trauma and other serious medical complications. The residents have a very large exposure to procedures and seemed very competent due to the high demands of the ED. They stated that they perform a good amount of chest tubes and even some thoracotomies and finish up their required quota incredibly quickly. The program faculty also seem very engaged and though the program may be new, the leadership has a lot of experience behind them. Borenstein in particular seems very resident-focused and has a pretty good vision for the program as well as the resume to back up his plans. The residents seemed to really enjoy their jobs and felt they were given a very fortunate opportunity to be given a thorough education. However, I had a hard time relating with him and I didn’t feel like I clicked very well with him. Since he’s basically the mastermind behind the entire program and has such a strong vision for what he’s trying to create, I feel like not being in sync with him is a much bigger negative than it would be with another PD at a different program.

Ultimately, I am ranking them low because I have strong priorities for location and potential for an academic career. I was not a huge fan of eastern Brooklyn as you would have to travel a decent amount (and not even by subway) to reach the rest of the boroughs. And while I do feel the trauma and patient exposure here is actually amongst the top of the programs I interviewed at, I still am biased against going to a new program with no name value and which hasn’t even graduated a class yet. I’m not interested in being part of growing a program from the ground up even if the people guiding it are well versed in the process. I’m definitely being shallow in my judgment here as I really do feel like this is going to be an underrated program with a lot of great advantages, and if I were able to overcome my internal love of name brand I might have ranked this much higher.

13. Brooklyn Hospital Center

In retrospect I probably shouldn’t have interviewed here, mainly because I knew that I would be ranking it very low and instead I ended up taking away an interview spot from my fellow applicants. As many people are likely aware, the program has been under probation multiple times over the years, though currently it is not. The reasons for it being under probation most recently were a poor board pass rate (~66% if I remember correctly) and inadequate emphasis on academics/education. A few years ago they brought in a new PD as well as a lot of new faculty and from what they said during the presentation, they revamped the residency education to account for the probation points. I believe they said they had a 100% pass rate the previous year and have maintained over 90% since the new faculty has come in. During the interview itself, the PD seemed very focused on wellness and supporting the residents. Unfortunately, I didn’t have a chance to go to the dinner and there were not many residents at the interview day so I met essentially none of the residents my entire time there. Many people would say to consider this a red flag, and for me, this was probably the nail in the coffin for a program that I already was coming into a little skeptical.

That being said, I do believe they are on the up and up due to their new influx of faculty and reemphasis on resident education. Having a fresh and enthusiastic program is a good thing in my book and as many of the new faculty are Brooklyn Hospital alumni, I think they are very motivated to improve the residency. During the interviews, the faculty were friendly and felt easy to get along with. Most of the leadership, including the chair and PD, are women, which doesn’t matter one way or the other to me, but a few of the female interviewees expressed that this was a big selling points to them. While I think the program is now much better than the reputation it has and will be better in the coming years, I’m not interested in being a part of that upswing. As for the program itself, residents rotate at different sites for some rotations, namely trauma at Brookdale and peds at Kings County. However, because of the new residency at Brookdale (see above) they are getting kicked out of that trauma rotation and were looking to rotate at Elmhurst. Meanwhile they are also trying to hire more PEM trained attendings to allow their residents to rotate in-house, but they weren’t able to give an estimated timeline or guarantee that this would happen. Currently, because they have off-site ped rotations, they do not incorporate integrated peds shifts throughout the year. For me, especially because I interviewed at those sites, I am not a fan of having to go to other hospitals to get training as I could just match at those residencies and train there directly.

Cons: Pretty straightforward, 4-year program at does all 12 hour shifts, without much or any academic focus, and doesn’t have the best reputation with history of poor board pass rates and probation. As I wrote above, I think the last part of that sentence is less relevant for future classes, but it’s always safer to go with a proven commodity. The random hospitals you have to rotate at for various rotations also felt like a big negative to me due to both the commute and I think I’d have a chip on my shoulder rotating at more well-known residencies.

Comments: During the interview day, nothing really felt like it fit with what I was looking for, but I admit this may be due to my preconceptions walking in. I still am ranking it though because while it didn’t fit me well, I do think that the quality of the education was good enough that I would greatly prefer it over going unmatched. I think that EM has done a very good job of overseeing resident education to where you’ll graduate from pretty much any program well trained to work in an ED so it’s more a matter of all the peripheral benefits. Looking at my list, it is very heavily weighted for location and reputation. Though related, neither of those things are directly a measure of the actual education you’ll receive. If I could somehow completely remove those two factors from consideration, I’d be very curious as to how my list would change.

Rejected from: Pretty much blanket applied to the regions where my interviews came from. Any program in those areas of comparable or higher reputation that seems like I would have been willing to interview at was a rejection or silent rejection.

Invited to interview, but declined: A few low-tier community hospitals, mostly from the NE.

 

[surely]

Huge thank you to all the applicants who contributed information to the spreadsheet. I've gotten some nice messages thanking me for all my work, but really, it was this awesome community of future EM docs who came together and added some transparency to this circus. Your stats, interview invites, ROLs and away rotation reviews are going to be so helpful to next year's class.

If I can impose one more favor: Now that the ROL submission deadline has passed, please consider filling out any info you may have kept under wraps up til this point, especially interview invite information and away rotation reviews.

I'm on a rotation with a pretty early start time, so I'll post the ROLs I've received tomorrow. Good luck, comrades.


Edit: Just noticed that this is my 900th post on SDN, and at this moment, I have a total of 555 likes!

 

[surely]

Submitted anonymously via PM.

Applicant Summary: DO
Step 1: didn’t take, Step 2: 240-250
COMLEX Level 1: 560-600 Level 2: 640-660
EM rotations: H/H/H/H
Medical school region: North East DO


Anything else that made you more competitive: very non-traditional student, brought up at every interview. 2 top 10% SLOEs, one from a place that gives around 5 per 100 rotating students. Took Step 2 early (Was told wouldn’t have gotten some of the interviews if I didn’t take Step 2.)

Anything that hurt your application: Being a DO (the bias is real) Not taking Step 1. SLOEs late, 1st one was uploaded in October 2nd in November.


Main Considerations in Creating this ROL:
1. COL and QOL, have a family to consider and a petting zoo worth of pets
2. Location
3. Fit with residents and staff
4. Clinical environment, want to do community EM and want to train in the same environment
5. one-on-one or close to it attending teaching. I have this listed as #5, but from my audition rotations places that offered this were by far my favorite.
6. Age and enthusiasm of attendings, want to train at a place with freshly trained attendings with diverse clinical backgrounds.


Of note: I applied to 100 programs between AOA and ACGME, only ended up with a few strictly AOA interviews, and canceled most of them. Applied only to programs with >10% DOs.


1) Inspira Medical Center Vineland
Pros – Lehigh trained PD. (Might not mean anything to SDN but locally it’s a great program) Rotated through this ED. Very busy ED. Residents mostly strong. Good pathology, Cumberland County is the poorest and sickest county in NJ and people are sick. The class that graduated last year were all real strong. Great on shift teaching. A lot of young enthusiastic attedings on staff. (Cooper Temple Jefferson). Nice sim lab. Trauma at Christiana, Peds at Dupont. Cheap COL, SO can continue working at current job (which is the main reason to put this program on top). Good moonlighting opportunities.

Cons – Not a trauma center. newly 3 years will have to see how the 3 year graduates compare to the 4 year ones. No only 1 class of alumni so far. Lots of time on translator phone.


2) Greenville Health Systems
Pros – This was my #1 until the day before ROL were due. Place is amazing, PD very enthusiastic, entire faculty passionate about making the place a hit. Population is very sick, and the catchment area is huge. On shift teaching is amazing. (spent a few shifts in the ED). ED was always busy. Good US exposure with fellowship trained faculty. Only met a few residents and they were nice, but hard to tell the culture. Faculty came to pre-interview dinner which was fun. Greenville is a cool town to visit.

Cons – New program, but they have a great plan in place. ED staff still getting used to residents. I feel bad about not ranking this place first, but it didn’t make financial sense to relocate.


3-5 were interchangeable for me, I would be happy at any of them. Hard time distinguishing.


3) St. Josephs Reg Paterson
Pros – PD is great (Lehigh trained) Pretty good name in the area. Residents easy to get along with. We send a lot of grads there being a former AOA program so the fit seemed natural. Rotated with graduates from this program and they were all amazing.

Cons – Newly 3 years. Paterson, NJ isn’t a great place to live didn’t want to commute to work.


4) Rutgers RWJ Brunswick
Pros: Busy, had to have been the busiest ED I seen on interview day. Everything done onsite except OB. Diverse patient population, homeless to very rich CEOs. New Barnabus Health merger should bring some community experience.

Cons: didn’t go to interview dinner so I can’t comment on the resident interactions.


5) Newark Beth Isreal
Pros – The PD is very honest with you about everything. Great speech about how to choose a residency. Children’s hospital onsite. Trauma at Rutgers University. Very sick and poor population. Possibly one of the best EMS fellowships if you are interested in it.

Cons – Older hospital. Currently no community experience, however with the merger this is changing. It is in Newark.


6) Lehigh Valley Hospital
Pros – Rotated here. May have been my favorite rotation of medical school. Senior residents were very strong. Amazing pathology. Lehigh affordable living, but not much to do. Great pay for the area.

Cons – 4 years isn’t for me. Didactics while strong seemed stressed more than clinical time. Consult heavy


7) Campbell University Cape Fear NC
Pros – High volume, high acuity. Very cheap COL. Fun group of residents, PD and APD have great vision and a good opportunity to make a great program.

Cons – New program, no food money, low pay. This program only has one spot in NRMP this year, but I figured I would rank them anyway.


8) University of Buffalo
Pros – Really Nice ED, good diversity rotating through different hospitals. Nice resident turnout at dinner and everyone seemed to get along well. New children’s hospital is completed with PEM trained faculty. Scholarly tracts seemed interesting.

Cons -Buffalo. Snow. Learning 4 EMRs for the different EDs. Interview day was way too long (included bus tour)


9) Rutgers NJMS
Pros – Great pathology, County feel. Had a great get turnout and good time at dinner. Interview day went very smooth. Would have ranked this place in top 5 if it was 3 years.

Cons – 4 years, residents admitted to a bunch of scut due to nursing issues. Newark,NJ


10) Mercy Health Muskegon, MI
Pros – seemed like a solid program. Hard to get a feel for it. Getting new ED, Cheap COL.

Cons – Muskegon. Snow. Recently ACGE with 4ish spots in NRMP.


11) Mountain State OVMC, Wheeling, WV
Pros - really liked the residents I met, Interview super chill. COL cheap.

Cons – Oldest ED on the trail. Didactics weak. PD was interesting. Not sure if the volume and resources will provide the necessary training in 3 years. Wheeling WV, horrible EMR

12) Argnot
Pros – Residents were great. Didactics seemed ok. Trauma at University of Rochester. Getting more sites as their volume is pretty low. New ED being built.

Cons – Low volume, low acuity. Newly 3 years.


13) NYCOMEC ORMC
Pros – new hospital

Cons – Really didn’t like this place PD is weird, no dinner so I didn’t meet any residents. Ranking to not SOAP.


14) Aria Jefferson, PA
Pros – Great pathology, 3 unique campuses. Residents were mostly strong. FM/EM and IM/EM were by far the strongest residents I encountered. Can live in Philly or easy commutes from NJ or burbs. Strong faculty, PD is super nice. As a student rotator you get tons of autonomy, more sutures than you could ever want, a few intubations, PIV, CIN placement splinting. U/S faculty is great.

Cons – Having rotated here I really enjoyed the place. Frankford can seem like an STD clinic at times and it is really draining. Didn’t click with some of the residency leadership and would only slightly prefer going here over SOAPing.


Overall impressions:

Including AOA I went on 19 interviews. It was a lot, but I truly enjoyed seeing new places. I had positive responses from every interview I went on and post-interview communication from quite a few. I didn’t enter the AOA match, I canceled most of my strictly AOA programs, and I feared if I ranked any of the dual programs I would have matched there and none of them were in my top 5. I did contact all of the dual programs and they stated they would rank me in the second match with no penalty for forgoing the AOA match. I don’t think I could have done better at any interviews so after my 8th or so I started declining or canceling places that I knew I wouldn’t want to go. Overall, I had just under 30 invites which I think is okay considering my lack of Step 1 and my late SLOEs. I would be happy to match at any of my top 10 as I feel the training will be fine.


Note from surely: Yesss, petting zoo crew unite.

 

[surely]

Submitted anonymously via PM.

Applicant Summary:
Step 1: 240s, Step 2: 240s
EM rotation grades: HP/HP
AOA: no
Medical school region: Midwest
Anything else that made you more competitive: non-traditional?

Main Considerations in Creating this ROL:
I have kids and spouse so a location they would enjoy was a big deal for me. I am looking for a family-friendly city ideally with good public schools. Bike-able city is a plus. Spouse works and was not crazy about 4 year programs which I think shaped my opinion especially after I got rejected by UMich, NW, and UCLA all in early Nov. As the season wore on I preferred academic to county. 45ish applications, 14 interviews which I think was too many.

I did a preseason ranking in early September which I have put in parentheses after the program name.


1) Wisconsin (3)
Blown away by this program. Madison is a great mid-sized town with lakes, tons of parks, good schools, UofW, and the state Capitol. In some ways, it felt like a better and much more well-funded version of Iowa. There is an option to do a 4th year in which you can almost customize a fellowship program but still be paid as a junior faculty member. The flight program is incredible, the event medicine opportunities are great, and all of the rotations seemed to be very well thought out. The program is committed to continuous improvement and really innovative about strategies to prevent burnout. There are rotations in Beloit that provide a community feel in a place that sees more penetrating trauma than Madison. The program seemed to be the best resourced EM program I saw on the trail thanks to a benefactor. Someone once told me not to chase money but rather chase good leadership. Dr. Westergaard was the most impressive PD on my trail and Dr. Hamedani (the Department Chair) had a clear vision about the future of the department while being incredibly receptive to new ideas for improvement. Oh, and they also had the highest pay I saw on the trail (58, 60, 62k) plus the medical plan was strong. A friend who lives in Madison said it’s a great family town with strong public schools. There were bike paths everywhere and the only other city on my list that was comparable was Minneapolis. I even heard that the bike paths are plowed in the winter. Easily my favorite program but SO is concerned about the long winters.


2) Kansas (6)
Rotated here. Pre-interview dinner was great. The residents seemed to have great camaraderie and the conversations were laid back and hilarious. While rotating, all of the residents (except for a single third year) and faculty seemed great and did a great job of teaching. Tended to be moderately consult-heavy but the attendings were also willing to try and address as much as possible in the ED. This is a new-ish program which still feels like it’s finding its place among the litany of residency programs at KU. Surgery runs the traumas while ED has the head of the bed and airways (although anesthesia seems to always turn up as well though I never saw them get involved). One of the new trauma surgeons is supposedly receptive to letting EM play a more integral role but I haven’t heard much more about this. A lot of other services spoke ill of the program although I’m pretty sure that this isn’t unique to KU. There is 1 month of community EM in Lawrence, which is about 40 minutes away. KU is very well respected in the area and is the place to go in KC for specialty care so the variety in pathology is great. Not as much peds but you rotate at Children’s Mercy quite a bit. Not as much penetrating trauma as Truman on the MO side but there were still quite a few GSWs and plenty of blunt trauma during my month. KU is definitely an academics-heavy place but they also serve a large amount of underserved and immigrant populations. The catchment area is huge (essentially all of northern and eastern Kansas) and specialists often draw from the entire state plus western Missouri. Not so much event medicine and flight is a one month elective. Kansas City is a fairly typical Midwestern city although I would say that people seem a little more relaxed than cities further east. Winters can be variable but are probably among the best in the Midwest. Spring and fall are typically long and pleasant with summers fairly hot and humid with long stretches of days >90 degrees. It’s not as fun as Chicago but it has a lot of big city amenities with a strong arts scene and minimal big city headaches. There are good schools in the KS suburbs, parks galore, and it’s a very family friendly place. Both SO & I love Kansas City so this program is largely buoyed by the town and I really liked the spectrum of pathology at KU.


3) USF - Tampa General (37)
This was the biggest surprise for me on the trail. The December weather was warm and the trees were green so perhaps that colored my view. The hospital sits right next to the bay on an island near downtown Tampa. The resident lounge has a deck that overlooks the water. All of that was great but the program really impressed me as well. All of the rotations were well thought out and very EM focused with very minimal scut. The new-ish PD seemed very receptive to resident feedback and seemed to try and keep the mood light. I felt like when I read this forum last year, people were like “great program but those 12 hour shifts”. It sounds like there has been a shift reduction and the 12’s are largely gone this year. Tampa General seemed like it that county-academic hybrid sweet spot nicely. Tampa was clean, beautiful, and friendly with more culture than I expected and there are great Gulf beaches about ½ hour away in St. Pete/Clearwater. They do flight and event medicine for the Buccaneers and Lightning. Also the Super Bowl will be here in 2021. This had a chance to crack the top 2 but despite the fantastic weather Florida has always felt a bit weird: fake almost. My SO has family in the state and has never really loved the idea of living in Florida and would prefer that this program be behind UVA. I’ve heard that the schools in Florida aren’t great. All of that said, the town and weather are beautiful and I loved the program. After Wisconsin’s PD, Dr. Derr was my favorite on the trail.


4) Virginia (41)
I really liked the program. Decent mix of married and single residents. Unique rotations included Peds Surg and IM floor. The PD said that he has been open to changing the rotations but the residents continue to think that both are valuable. They have a track program where beginning in 2nd year you can get a shift reduction for work within an EM subfield. The residents seemed happy and they all lauded the support of the faculty and each other. Opportunities for flight, and event medicine (NASCAR, UVA sports). New ED opening in July 2019. There did seem to be some boarding issues particularly with psych patients. Charlottesville seemed like a great town with a lot more to do than you might expect for a town its size (~55k). The downtown pedestrian mall was quite nice, the horizon is ringed with small mountains, and there is great hiking within an hour or so. Overall, really liked the program, Charlottesville seemed a bit small, and I was a bit concerned about the boarding issue.


5) Iowa (17)
I arrived the night before and really was not very impressed with Iowa City. On interview day however, I was really impressed with the program. There is a lot of elective time and the faculty seem like they really want to tailor the residency experience to help you get the most out of the program. Orientation month seemed like a blast and it’s capped off by working with EMTs for a bike race across the state. While Iowa City doesn’t appear to have much patient diversity, you do spend two months in Cedar Rapids where you see the typical mid-sized city pathology including trauma. The flight and peds experience seem to be pretty robust and you can work Hawkeye football, basketball, and wrestling. Most of the residents seemed to be from Iowa. I was prepared to not really like the program after the night before but ended up really liking the program. Slipped a bit because SO isn’t crazy about the idea of Iowa City.


6) UMKC – Truman (35)
Pre-interview dinner was delicious but the restaurant was loud and crowded which made it difficult to have conversations with people not sitting nearby. The residents seemed liked a happy bunch that enjoyed hanging out with one another. One resident said that he would rank the program higher if he had to do it over again. The faculty were laid back and did seem committed to teaching. Not very consult-heavy and EM seems to run the traumas: second years get airways, third years run the trauma. 8 hour shifts with extra ½ hour overlap. Some residents leave on time but occasionally stay ½ to 1 hour to finish documentation. First years get to pick interesting patients and work 15-17 shifts. Second years run the pods and work 20-21 shifts. Third years supervise and work 18-19 shifts. There is no difference in acuity between the pods although there is a psych pod (staffed by residents) and a fast track (staffed by NPs & PAs). 1 month/year at Children’s Mercy, which is adjacent to Truman and also 1-2 shifts per month at Mercy during 2nd and 3rd year. Off-service rotations seemed to be enjoyed with the exception of 2 weeks on Ortho. Many of senior hospital officials are from EM so the ED has a lot of pull in the hospital. It’s a county hospital with limited resources and I heard many times that the patient population can be difficult with lots of psych and high turnover in support staff. Both I and my SO love KC so this program is at #6 and has been creeping up my list mostly on the strength of the city. All in all a pleasant surprise with strong faculty committed to education and happy residents but I’m don’t think that county is my thing.


7) Virginia Commonwealth (4)
I interviewed here a few days after UVA and the programs themselves seemed very similar. There are optional track programs starting in year 2 that span most EM fellowships. The patient population in Richmond was quite different though in that they have a large proportion ~30% of that is underserved. They did mention a specific program that provides a path to covered PCP visits for those without insurance. The residents seemed pretty happy and it the faculty is strong. Residents specifically mentioned that there are great female attending and there is a fairly active FemInEM chapter here. The trauma/resus bay was the biggest I had seen and they do a lot of cool stuff in the department like TEE and ECMO. Residents praised nursing and support staff. Richmond has a lot going on: great art museum, recreation in and along the James River, Carytown, Botanical Garden to name a few. It sounded like schools aren’t the greatest so residents with kids live in the suburbs. Some flight and event medicine (NASCAR) but not so much for VCU or U-Richmond athletics. Overall, I liked (but didn’t love) the program and liked (but didn’t love) Richmond.


8) Christus Spohn – Texas A&M Corpus Christi (20)
Good program with great laid-back people. EM seemed like the strongest program in the hospital and they run the show on traumas. Good patient and acuity variety. They serve a large Hispanic population but most are native English speakers. Again, I was wowed by the warm weather and the beach but I just couldn’t shake the feeling that Corpus Christi was pretty isolated. The downtown area didn’t have much going on but the area around the hospital seemed nicer. Many residents could afford houses but the public schools in Corpus are allegedly not great. They use Meditech EMR (yikes!) but the residents said that they were good at navigating it often with no keystrokes. All in all, I liked the people, the program, and the weather but Corpus felt like it was far away from everything.


9) Kentucky (25)
I really liked this program, and the residents were among my favorite on the trail. I really liked Drs Desai (PD) and Bronner (APD) as well who both really had a way of making me feel at ease. The program had all the bells and whistles I cared about: flight, wilderness, and event. This program just really slipped based on location. I was hoping to love Lexington but I just wasn’t feeling it. There just didn’t seem like there was a ton to do if you’re not into Bourbon and/or horses. Also, Rupp Arena=meh. The hospital was beautiful and although there is a significant boarding issue, the floors still took responsibility for the patients. The people here were fantastic and if I were flying solo this would probably have been in the top 5 but it just felt like Lexington would be tough for the fam.


10) Illinois Peoria (11)
This program has robust flight with good peds but limited event medicine. They do have an optional tactical medicine rotation where you work with the Peoria County SWAT team for a month. Most of the faculty seems to have graduated from the program. The program is at a Catholic hospital but the PD addressed this straightforwardly with the only thing different being a prohibition on elective contraceptive medication in the ED. The ED is definitely one of in not the nicest I saw on the trail and there is a unique calmness to it which I think is due to its layout. A large part of why this program isn’t higher on my list is Peoria. It seems OK for a smaller city amenity-wise but there just seems to be a Debbie Downer vibe to the town. Caterpillar recently moved its corporate HQ to Chicago and while most of the jobs are staying in the area, it was a pretty big blow to the town’s psyche. The program seems solid and I wanted to like it more but I just can’t get over the location. I have ties to the area but SO doesn’t like Peoria.


11) Hennepin (40)
Low preseason rank but the name kind of wowed me. I really liked Minneapolis and the third year residents seemed very confident in their clinical abilities. The faculty did seem strong and the hospital seemed very well resourced for a county program. The graduated responsibility didn’t scare me and I loved the very minimal consult mindset. These guys RUN the traumas and surgery is simply consulted. You will be trained to practice the full scope of EM. Nevertheless, I never quite got the warm and fuzzies and couldn’t shake the feeling that the program wasn’t the right fit for me. There isn’t much elective time, minimal flight (1 shift unless you choose it as an elective) and event medicine seemed reserved for EMS fellows. Some of the off-service rotations (Medicine floor & Neurosurgery) seem to be controversial and I wasn’t convinced of their utility. Hyperbarics was fairly unique and the Tox rotation seemed great. This is a fantastic program that I believe churns out great EM docs but I’m just not sure it’s for me.


12) Western Michigan (44)
Huge program, 20 residents per year. EMS is king here with active flight and ground but the flight sounded a bit more like a shadowing experience. The do have a physician EMS vehicle that responds to field codes, car wrecks, and per EMS request and the whole thing really seemed awesome. It sounded like there are some opportunities for event medicine but it is not a well-worn path. 2 hospitals, one with Epic, one with Cerner. The residents seemed a bit eclectic but I guess that is to be expected with such a large class and they all were happy with their choice. I really liked the EMS stuff but man, I was not impressed at all with Kalamazoo. The town was kind of run down and the nice part of downtown was fairly limited. WMU’s undergrad campus seemed OK but really the rest of it was not that great. Overall I liked (but didn’t love) the program but Kalamazoo really pushed this program down the list.


13) Henry Ford Detroit (42)
Strong training program in which EM largely runs the show. I thought that it was a decent mix of county and academics with a commitment to the underserved. Critical care is very strong here. I loved the resident who gave the tour but didn’t feel like I jived as much with the others. In the interviews, I really didn’t jive with at least two members of the faculty including the PD. They seemed I thought, overly content with to rest on their laurels and not really progressive in making changes to curriculum. I actually really liked Detroit though even though it was frigid on interview day. It seems like the city is really bouncing back. They put it us up in a really cool hotel which was nice. This one fell based on gut feeling but I still feel like they produce great docs.


14) Michigan State Grand Rapids (26)
These were probably the happiest residents I met on the trail. Quite a few seemed to be married and from western Michigan. The program was solid, all at one site if memory serves, but there weren’t many options for customization, flight, or event medicine. Grand Rapids was much nicer than anticipated and there are apparently a few wealthy families that are very committed to making the town a nice place to live. Beautiful Lake Michigan beaches less than an hour away. The program director is transitioning out of the role by the end of 2017 but the interim APD seems to be picking up to role nicely. Overall, great residents, good town, but the program wasn’t as flexible as some others.


PS: The recent USA Gymnastics sex abuse fiasco (not EM but still a MSU doc, and more so the institution’s handling of the situation) made this program slip way down the list for me.



Withdrew before decision: Orlando Health (39); Central Michigan (46); Christiana (47) I was high on this program last spring and by all accounts is fantastic but the more I researched the area the less family-friendly it seemed; St. John’s Detroit (48)


Invited to interview but declined:
Denver (13): as the season progressed I decided I wasn’t so in to 4 year programs and I’m not sure that the fit would have been great for me, similar to Hennepin. Denver has gotten really expensive;
Southern Illinois (28): I’ve met some resident and the PD whom I thought were great but I’ve been to Springfield before and really didn’t like it
Wash U St Louis (34): The invite came in fairly late in the season and again the appeal of 4 year programs had really faded by then;
Arkansas (43): Little Rock didn’t have much appeal;
Nebraska (45): I’ve been to Omaha before and thought it was just OK, also the zoo is over-rated

Waitlisted: UC Davis (36) seemed like a good program and have family in NoCal but a waitlist spot never really opened up and the dates didn’t really work for me. Also, I love California but the COL, even in Sacramento, is tough to swallow for a Midwesterner with a family. I know, I know why did I apply to Kaiser and UCLA then? I guess I liked those programs better in the preseason and SoCal’s weather and beaches might have made their even higher COL worth it.

Rejected by:
Michigan (1) this one stung the most since I had strong ties to Ann Arbor and UofM; Maine (7) bummer; Regions St. Paul MN (9); Kaiser San Diego (14) family member works in Kaiser system on the East Coast and loves it; Cincinnati (15); Northwestern (21); Ohio State (22) did not hear good things on the trail; Utah (23); Brown (24); Carolinas (27); U Chicago (29); New Mexico (31); UCLA Harbor (32); Pittsburgh (33); North Carolina (38)

Silent Rejection: Vanderbilt (2): sent a love note in November but no response; Wake Forest (5); Indiana (8); Medical College of Wisconsin (10): heard great things about them on the trail; Medical University of South Carolina (12); Advocate Christ (16); Duke (18); Maricopa (19); Arizona main campus (30)

Toughest Rejects: Michigan (but softened a bit as the season went on since it’s a 4), Vandy (really thought I would have fit in well here), Wake (seemed super family friendly), Maine (was excited for the adventure), Regions (loved the Twin Cities and I think I would have fit in here much better than Hennepin), MCW (mostly based on the great things I heard on the trail).

Final Thoughts: I should have tried to get an away at a more prestigious place because both my home and away institutions aren’t really top tier programs. I had advice to limit my ERAS applications because there may be sour grapes if you are offered an away and don’t accept. I’m not so sure about that advice especially since my first 2 choices fell through in May-June which kind of left me scrambling. I also should have been more flexible about which month I was willing to schedule my away in. I liked Michigan’s program and should have really tried to set up an away there.

UC Davis was my only invite west of the Rockies so it felt like regional bias was a thing (even though I didn’t apply to heavily out West).


Note from @surely: Really like what you did with the pre-season ranking.

 

[surely]

Submitted anonymously via PM.

Applicant Summary:
Step 1: 210s, Step 2: 230s
COMLEX 1: 520s, COMLEX 2: 620s
EM rotations: H/H/H
SLOE's: Top 1/3, Middle 1/3
Medical school region: Southeast DO


Main Considerations in Creating this ROL: Location, Faculty/Residents, Vibe.


ACGME:
1) WellStar Kennestone- Marietta-GA.

New program but I have absolutely no doubt they are destined for great things. I'm very impressed by the PD, faculty and facilities and I love Atlanta.


2) Sunrise - Las Vegas, NV

Back to back new programs. Again love the location and was very impressed by the faculty and PD. Excellent trauma exposure and a unique place to train (50% tourists at Sunrise)


3) UPMC Hamot - Erie, PA

Loved my rotation there and was very impressed by the residents and faculty. I'm from a northern state so I don't mind the cold or snow. Erie was very nice in the summer while I was there.


4) Kent - Warwick, RI

Taylor Swift lives in Rhode Island and we are destined to be together. I loved the location, it's an hour from Boston and only 20-30 minutes from the Atlantic. Downside is that it is remaining a 4 year program and the hospital is a bit run down. Great people top to bottom made this an easy inclusion in my top 4.


5) St. Mary Mercy -- Livonia, MI

Brand new ER and recently renovated hospital. Strong leadership and cool residents. Also staying a 4 year program which is a drawback. Detroit is much nicer than I pictured and I would be happy to live there.


6) Mercy Health -- Muskegon, MI

This was the biggest surprise for me. I frankly went into my interview with only modest expectations and left very impressed. I like being close to the lake and I was very impressed by all the faculty and residents I met. Again, downside is that they are staying a 4 year program.


7) Conemaugh -- Johnstown, PA

I can not say enough good things about the people here. The PD, APD and all of the residents that I met and worked with were stellar. Location is a tough sell. I have no doubt that I would become a good EM doctor if I match here.

8) Orange Regional -- Middletown, NY

9) Mountain State -- Wheeling, WV

10) Memorial -- Marietta, OH

 

[surely]

Submitted anonymously via Google Form.

Applicant Summary:
Step 1: 210s, Step 2: 230s
EM rotation grades: High Pass/High Pass/ High Pass
Inducted into Alpha Omega Alpha: No
Medical school region: Midwest
Anything else that made you more competitive: Great SLOE's despite not so great Step 1 improved Step 2. Research. Held several leadership positions on campus.

Main Considerations in Creating this ROL: Diversity amongst the residents, faculty, pt population. County/Academic

1) Emory University School of Medicine
I loved my interview day, the residents and program leadership were down to earth. I truly felt at home and that I would fit in. Loved that most of the time is spent at Grady.


2) University of Chicago Medicine
Pros: Great residents, Loved the PD. Felt like a lot like my number 1. Only 2 because I ready for a change in location. Excited about the new trauma city and what that will provided to the Southside of Chicago.


3) Washington University St. Louis/Barnes-Jewish Hospital
Loved the faculty, the PD/APD gave a great sale of the program. 4 years seem worth it. Not graduated responsibility like some of the other 4 year programs. They are the safety net hospital for STL.

Cons: residents not as diverse as I would like.


4) University of Michigan
Great program, strong 4 years. Residents well treated, so you can focus on being a resident. Different training sites, ICU in ED.

Cons: College town, not as diverse of patient population as I wanted.


5) University of Illinois Hospital - Chicago
Pros: Love the PD and APDs. Strong clinical training from various sites throughout the city.


6) Case Western Reserve University/University Hospital Cleveland Medical Center
Pros: Love this program, PD was awesome and is working hard to continuously improve it. Cleveland was a surprise in terms of what it has to offer.


7) Ohio State University Medical Center
Pros: Great clinical training, strong research program. Columbus is a great city.

Cons: Much more academic than I wanted.


8) Louisiana State University - New Orleans
Pros: Loved the residents, the vibe of the interview day was one of the most relaxed I had attended.

Cons: Like to visit New Orleans, but did not think I could live in NO.


9) HealthPartners Institute/Regions Hospital
Pro: Everyone was super friendly, would get great clinical training. The most wellness focused residency. If I had a family and a significant other this program would be way higher on my list.

Cons: Just not in a family vibe way yet in my life.


10) John H. Stroger, Jr. Hospital of Cook County
Pro: Strong EM program, large alumni network, has the pt population, diverse residency class.

Ranked lower because I had an odd interview day and pre interview dinner.


11) Boston Medical Center
pro: Loved the mission of the program, all the resources they provide for their patients. The training is great.

Cons: just did not feel like i fit in, COL in boston is too high which I knew when I applied but was willing to overlook.


Anything else to add?
As you can see I did not have the strongest Step 1 score. However I worked hard to improve on Step 2 and I made sure to knock my away rotations out of the park. I was told because of my numbers that I should apply to 60+ programs. I ended up applying to 68 and received 29 interviews and was waitlisted at 3. It truly seems that SLOEs really helped someone in my position. I am so grateful. So remember get at good SLOE, because even with excellent Step scores a bad SLOE can do damage. Also I for sure released interviews as quickly as possibly if I knew I did not want to attend.

Applied to:
University of Alabama Birmingham, Yale, George Washington, Georgetown, Christiana Care, Jackson Memorial, UF Jacksonville, UF Gainesville, Emory,Rush, University of Chicago, University of IL Chicago, Advocate Christ, UIC-Peoria, Southern IL University, Cook County, Presence Resurrection, University of Kansas- Kansas City, University of Louisville, University of Kentucky, LSU-New Orleans, Boston Medical Center, Mass General, John Hopkins, University of Maryland, Central Michigan University, Detroit Receiving, Henry Ford, Michigan State- Spectrum, Michigan State- Sparrow, William Beaumont, University of Michigan, Hennepin, Regions Health Partners, Mayo, UMKC, Washington University in St Louis, St Louis University, Wake Forest, UNC-Chapel Hill, Hackensack, Cooper, Rutgers Newark, Jacobi/Montefiore, NYU-Metro, NYU Presbyterian, NYU, Stony Brook, SUNY-Downstate, NYU-Queens, The Ohio State, Wright State, Case- University Hospital, Case- Metro, Drexel, Allegheny, UPMC, Thomas Jefferson, Medical University of South Carolina, Vanderbilt, UT- San Antonio, UT-Houston, Baylor, John Peter Smith, Virginia Commonwealth, Medical College of Wisconsin,

Invited to interview, but declined:
UT- Houston, Baylor, Jacobi/ Montefiore , Yale, Hackensack, Cooper, UMKC, University of Kansas, William Beaumont,UAB, Christiana Care, UF Gainesville, Presence Resurrection, William Beamont, Allegheny,

Rejected by:
UPMC, Thomas Jefferson, Vanderbilt, UT-San Antonio, John Peter Smith, Virginia Commonwealth, Medical College of Wisconsin, Wright State, NYU- Queens, Case- Metro Health, Drexel, Stony Brook, NYU Presbyterian, NYU Metro, Rutgers NJ, UNC-Chapel Hill, Wake, St Louis University, Mayo, Hennipin, Sparrow and Spectrum- Michigan State, Henry Ford, Detroit Receiving, Mass Gen, University of Maryland, University of Kentucky, University of Louisville, UIC-Peoria , Advocate Christ, UF Jacksonville, Jackson Memorial, George Washington, Georgetown, Northwestern( Waitlist), Hopkins( Waitlisted), NYU (Waitlisted)

 

[jw3600]

Submitted anonymously via Google Form.

Applicant Summary:
Step 1: 210s, Step 2: 230s
EM rotation grades: High Pass/High Pass/ High Pass
Inducted into Alpha Omega Alpha: No
Medical school region: Midwest
Anything else that made you more competitive: Great SLOE's despite not so great Step 1 improved Step 2. Research. Held several leadership positions on campus.

Main Considerations in Creating this ROL: Diversity amongst the residents, faculty, pt population. County/Academic

1) Emory University School of Medicine
I loved my interview day, the residents and program leadership were down to earth. I truly felt at home and that I would fit in. Loved that most of the time is spent at Grady.


2) University of Chicago Medicine
Pros: Great residents, Loved the PD. Felt like a lot like my number 1. Only 2 because I ready for a change in location. Excited about the new trauma city and what that will provided to the Southside of Chicago.


3) Washington University St. Louis/Barnes-Jewish Hospital
Loved the faculty, the PD/APD gave a great sale of the program. 4 years seem worth it. Not graduated responsibility like some of the other 4 year programs. They are the safety net hospital for STL.

Cons: residents not as diverse as I would like.


4) University of Michigan
Great program, strong 4 years. Residents well treated, so you can focus on being a resident. Different training sites, ICU in ED.

Cons: College town, not as diverse of patient population as I wanted.


5) University of Illinois Hospital - Chicago
Pros: Love the PD and APDs. Strong clinical training from various sites throughout the city.


6) Case Western Reserve University/University Hospital Cleveland Medical Center
Pros: Love this program, PD was awesome and is working hard to continuously improve it. Cleveland was a surprise in terms of what it has to offer.


7) Ohio State University Medical Center
Pros: Great clinical training, strong research program. Columbus is a great city.

Cons: Much more academic than I wanted.


8) Louisiana State University - New Orleans
Pros: Loved the residents, the vibe of the interview day was one of the most relaxed I had attended.

Cons: Like to visit New Orleans, but did not think I could live in NO.


9) HealthPartners Institute/Regions Hospital
Pro: Everyone was super friendly, would get great clinical training. The most wellness focused residency. If I had a family and a significant other this program would be way higher on my list.

Cons: Just not in a family vibe way yet in my life.


10) John H. Stroger, Jr. Hospital of Cook County
Pro: Strong EM program, large alumni network, has the pt population, diverse residency class.

Ranked lower because I had an odd interview day and pre interview dinner.


11) Boston Medical Center
pro: Loved the mission of the program, all the resources they provide for their patients. The training is great.

Cons: just did not feel like i fit in, COL in boston is too high which I knew when I applied but was willing to overlook.


Anything else to add?
As you can see I did not have the strongest Step 1 score. However I worked hard to improve on Step 2 and I made sure to knock my away rotations out of the park. I was told because of my numbers that I should apply to 60+ programs. I ended up applying to 68 and received 29 interviews and was waitlisted at 3. It truly seems that SLOEs really helped someone in my position. I am so grateful. So remember get at good SLOE, because even with excellent Step scores a bad SLOE can do damage. Also I for sure released interviews as quickly as possibly if I knew I did not want to attend.

Applied to:
University of Alabama Birmingham, Yale, George Washington, Georgetown, Christiana Care, Jackson Memorial, UF Jacksonville, UF Gainesville, Emory,Rush, University of Chicago, University of IL Chicago, Advocate Christ, UIC-Peoria, Southern IL University, Cook County, Presence Resurrection, University of Kansas- Kansas City, University of Louisville, University of Kentucky, LSU-New Orleans, Boston Medical Center, Mass General, John Hopkins, University of Maryland, Central Michigan University, Detroit Receiving, Henry Ford, Michigan State- Spectrum, Michigan State- Sparrow, William Beaumont, University of Michigan, Hennepin, Regions Health Partners, Mayo, UMKC, Washington University in St Louis, St Louis University, Wake Forest, UNC-Chapel Hill, Hackensack, Cooper, Rutgers Newark, Jacobi/Montefiore, NYU-Metro, NYU Presbyterian, NYU, Stony Brook, SUNY-Downstate, NYU-Queens, The Ohio State, Wright State, Case- University Hospital, Case- Metro, Drexel, Allegheny, UPMC, Thomas Jefferson, Medical University of South Carolina, Vanderbilt, UT- San Antonio, UT-Houston, Baylor, John Peter Smith, Virginia Commonwealth, Medical College of Wisconsin,

Invited to interview, but declined:
UT- Houston, Baylor, Jacobi/ Montefiore , Yale, Hackensack, Cooper, UMKC, University of Kansas, William Beaumont,UAB, Christiana Care, UF Gainesville, Presence Resurrection, William Beamont, Allegheny,

Rejected by:
UPMC, Thomas Jefferson, Vanderbilt, UT-San Antonio, John Peter Smith, Virginia Commonwealth, Medical College of Wisconsin, Wright State, NYU- Queens, Case- Metro Health, Drexel, Stony Brook, NYU Presbyterian, NYU Metro, Rutgers NJ, UNC-Chapel Hill, Wake, St Louis University, Mayo, Hennipin, Sparrow and Spectrum- Michigan State, Henry Ford, Detroit Receiving, Mass Gen, University of Maryland, University of Kentucky, University of Louisville, UIC-Peoria , Advocate Christ, UF Jacksonville, Jackson Memorial, George Washington, Georgetown, Northwestern( Waitlist), Hopkins( Waitlisted), NYU (Waitlisted)

Your interview haul was incredible with what seems to be a fairly average app. Well done.

 

[surely]

Submitted anonymously via Google Form.

Applicant Summary:
Step 1: 230s, Step 2: 230s
EM rotation grades: High Pass/High Pass/Honors/Honors
Inducted into Alpha Omega Alpha: No
Medical school region: Northeast
Anything else that made you more competitive: NIH research grant, former EMT, 5+ pubs.

Main Considerations in Creating this ROL: Most significant factor was lining up w/ SO also applying to grad school. Prioritized being together over my favorite places to train. Personally preferred 3>4, no strict geographic ties, preferred bigger cities over rural areas.

1) University of Pittsburgh Medical Center
Pros: Has been my #1 since before med school. Fantastic reputation in the EM world. Major training sites with Presby-flagship hospital with complex patients and amazing critical care, emphasizing self sufficiency. Mercy- Community inner-city style site with pit boss role emphasized; Childrens with advanced pediatric care; Shadyside with very sick cancer care; and the Jeep all around the city of Pittsburgh. Unparalleled EMS experience,fantastic sim experience, incredible tox, and great teaching faculty. Pittsburgh is a fantastic low LOC city to live in. Loved hanging out with and working with the residents there. They definitely work hard, but they play hard too (cliche I know, but they definitely embodied it)

Cons: Ultrasound is ok, but could be better. Not my situation, but not ideal social environment for those with families/older. Trama airway not ideal at presby, but better at Merc


2) University of Florida - Gainesville
Pros: Heavily emphasized resident wellness and transparency. Seem very responsive to resident goals and very adaptable. Relativley new program but seem very solid at a major academic medical center. Warm and sunny, low COL, Gainesville is very pretty with a lot of cool restaurants and bars. Ideal location for SO. Close to Orlando, Jacksonville, and Tampa.
Cons: Gainesville seems dominated by UF, which is nice to a certain point, but social environment for 25-35 yo seems somehwat limited. definitely much higher on my list due to SO, but I know I'd be happy as a resident here and get great training, so I'd be ecstatic to match here


3) University of Maryland
Pros: Amazing teaching faculty and everything about the program focuses on training excellent clinicians for leadership in academic emergency medicine, but in a 3 year program. Whiteboard teaching every shift in the ED, great off service rotations, and team based training, which is my ideal training style if I can have just one. Amazing range of pathology, lots of tox cases, Shock trauma offers best trauma in the country.

Cons: Baltimore is not a great place to live, very expensive and very dangerous, residents are great doctors, but don't seem to have much of a social connection or hang out much outside the hospital. Workload is one of the highest in the country.


4) Hennepin County Medical Center
Pros: Amazing county program with major academic level resources for research and education. STAB room proficiency and ownership over all critical cases forges amazing emergency physicians, trauma and other specialties are used only out of necessity when leaving the ED. Great faculty and adaptability of program to target rotations to resident needs. Pit boss role teaches you to learn how to supervise and learn how to run an ED. MInneapolis is a really fun city to live in, HCMC right in the middle of the city across the street from US Bank Stadium.

Cons: Peds could be stronger, seems like they all go to University of Minnesota. So, so cold. Literally the coldest metropolitan area in the US. I'm from north of the Mason-Dixon line and I was told that's a "warm weather" state to them. That being said, how much difference is there really between 10 and -10?


5) Jackson Memorial Hospital
Pros: Honestly who doesn't want to live in Miami? Only their second year but seems like they've been around for 15+. Best interview I had on the trail, loved hanging out with the residents and talking with faculty. Very strong clinically with great residents and simulation. Strong trauma with Ryder Trauma Institute and academic backing of University of Miami.

Cons: Large amount of rotations at Holy Cross hospital in Ft. Lauderdale where physicians are employed by a separate group, not crazy about training under physicians not employed by the health system. No 3rd year residents yet so logistics not totally clear on program overall. Miami has very high COL, but you know, beach so...


6) West Virginia University
Pros: The energy of this program eminated from every moment of the interview. PD and APD are an amazing combo. The residents seem to absolutely love it there and had nothing but great things to say about the program. Patients in WV are very sick, and major center for the region.

Cons: WVU is a major college party town, outside of going to houseparties idk what I woud do for fun. Had fun with the residents, but not sure they vibe super well with my personality type.


7) University of Virginia Health System
Pros: Great academic and teaching environment. Charlottesville seems like a great place to live with lots to do. Faculty and residents seemed like great people.

Cons: Almost seemed too academic at times, and I even did a bunch of research. Didn't quite get the click I was expecting at this program, but to be fair I came in with high expectations and there's little that I can criticize. Just didn't quite feel the perfect fit type of feel.


8) Allegheny General Hospital
Pros: Seemed like a decently solid clinical program and Pittsburgh is a great city to live in as mentioned above. Residents seemed social and supportive

Cons: 50% of faculty are with a private group, residents were very weird and dodgy when asked if there were things that they didn't like about the program.


9) Wellspan York Hospital
Pros: Suprisingly new hospital/ED and friendly/engaging faculty. Seemed like a good program

Cons: York does not seem like a good place to live. Residents just seemed kind of off when talking about the program. Seems like a good place to train, just not in the best of places


10) East Carolina University/Vidant Medical Center
Pros: PD was great and seems very supportive. Strong clinical environment, huge catchment area, not many other residents stealing patient care/procedures from us.
Cons: hardly got to meet with residents, Greenville is in the middle of nowhere


11) St. Luke's University Health Network
Pros: Sneaky good program. PD and faculty were super friendly. Limited residencies and strong administration protect patient care and procedures from other services.

Cons: Bethlehem not the greatest place to live, cool main street but not much outside of that. Alumni of program don't seem to reach far outisde of Eastern PA geographically


12) Conemaugh Memorial Medical Center
Seems like a good program overall, just not sold on living in Johnstown for 3 years.


13) Geisinger Medical Center
Didn't vibe with the facutly here well. Was asked over and over again about where I was interviewing. PD had nothing but negative things to say about everything I said in the interview. Second year resident said that she had yet to do a central line or an a-line.


14) Rutgers Robert Wood Johnson Medical School
Not interested in doing a 4 year program, but I'd rather do that than not match


Anything else to add? List may have looked a bit different up top without SO, but I'd be very happy to match anywhere in my top 8


Invited to interview, but declined: Drexel, Jeff, PSU, Dartmouth

Rejected by: Emory, OSU, Denver, UNC, Duke, Temple

 

[surely]

Submitted anonymously via Google Form.

Applicant Summary:
Step 1: 240s, Step 2: 250s
EM rotation grades: Honors/Honors
Inducted into Alpha Omega Alpha: No
Medical school region: West coast
Anything else that made you more competitive: Top 10% SLOES. Strong LOR's. Lot's of cool hobbies and this was talked about at every interview.

Main Considerations in Creating this ROL: Gut feeling. 3>4. COL/QOL during residency. Fun residents. 90% will do community long term.

1) University of Arizona
Tucson has a small city/big town feel. Low cost of living.. I can afford a house with a pool. This will significantly improve my Tinder game from excellent to absolutely stellar. Seriously, though.. a very strong program with down to earth residents and strong faculty. Lot's of great EMS research coming out of here. Academic environment at University Hospital and more rural exposure at South Campus. This place just felt right.


2) Maricopa Medical Center
Fantastic training. Very hand's on with lots of autonomy. Copa pride is real and the residents seems like the most down to earth bunch. Seems like I wouldn't have to worry about making jokes and being myself here. The only downside is Phoenix. I just really don't know how I would feel living in that city. PD amazing. Huge focus on resident wellness. Ultrasound teaching seemed top-notch. Overall, felt straight up county and raw with good people.


3) University of Utah Hospital & Clinics
A solid 3 year in an amazing location. Residents all seemed happy and loved to get outdoors. I'm not gonna lie, this program is 3 because if I match here I can convince myself I gave it a good shot, but the gods really just wanted me to ski as hard as I could during residency.

Awesome PD. Tight knit group. Didactics seemed strong at least at the one I sat in on. Felt like my kind of people. A question for me was lots of SICU and surgical taste to everything being a department of surgery. Didn't get a great answer when I asked the PD about this.


4) University of New Mexico
Amazing 3 year. Strong CC. Would love to participate in the Diploma of Mountain Medicine training. Cheap COL. I wanted to put this 1, but I just couldn't shake the crime. Abq has great outdoor access, but I just didn't feel right here. I spent a day exploring around town and just felt like I wanted to leave the whole time. Everyone was realistic about the crime and talked about their cars getting broken into and one of the residents recently had a house break in I think. While I hated UCLA RR because it was so ****ing ritzy, this just felt a bit too meh for me to be happy and have a partner feel safe. Really strong clinical training and probably the best resident wellness.


5) Kaiser Permanente San Diego Medical Center
3 years in San Diego. I will likely do community and was convinced this is a great place to learn community medicine. Turn off was only 6 residents and feeling it may be a bit too low acuity. Had one interview that was a complete turn off, but overall liked the faculty. Beautiful new hospital. Would be stoked to match here for location and feel it would be a good foot in the door to Kaiser system.


6) Alameda Health System - Highland Hospital
Don't need to say much. Absolute powerhouse in an area that I like. Total turn off interview with one faculty member where he tries to talk you out of EM, but otherwise loved everyone else I met. Downside to me was 4 years.

9) University of Cincinnati College of Medicine
Had an amazing time here. Godfather of EM and it shows. Flight is a dream of mine and I wanted to put #1, but couldn't convince myself 4 years and location. Loved the faculty. Loved the residents. I feel they have the best 4 year curriculum that I saw. The hotel they put you up in is awesome and a solid place for Tinder dates.

Seriously I love this place and secretly hope I end up here.


10) University of Washington Emergency Medicine Residency
Program Seemed like a great program in a great location. Not sure how I could swing Seattle living on a pretty low pay. 3 weeks vacation? Intern year seems brutal. Great training at academic UW site, straight county Harborview, awesome Seattle Childrens hospital, and community at Valley.

No doubt would be great training, just not sure I want to live in a studio for 4 years.


11) Maine Medical Center
Loved this place, just too far from home. Seems like they prepare you well to work in any environment, which I liked. They even had some people go straight into working in rural Alaska. If I was from that region I would put this top 3.


12) University of California San Francisco/ Fresno
HOLY ****! This place is INSANE. Rotated here and I think hands down they have some of the best clinical training. The pathology and volume through here is out of control. Even as a med student I got 4 intubations, 3 LP's, 3 central lines, an ankle reduction that was gnarly and would have been pure consult anywhere else, etc. I loved this place and could talk it up forever. Downside is Fresno. Hot and blah. Don't want to live here 4 years. Yosemite and other national parks make up for that a bit, though.

In another life this will be my number 1. If you can swing Fresno.. GO HERE.


13) Brown University
Far from home. Strong CC. Name recognition. Really enjoyed my interviews and the faculty. Super down to earth folks even with the big name.

Just like Maine, if I was from East coast I would put this top 3.


14) Stanford University Medical Center/Kaiser Permanente Medical Center
Way too academic. Questionable clinical training. The county experience is too short in my opinion. The county attending on our tour said "we run perfectly fine without residents so if county isnt your thing you can just show up and get through this." That stood out to me, but take it as you will.

If you have interest in anything else outside of just learning to be an EM doc, I'm positive they can help you get there. Resources are crazy.

COL is absurd.


15) University of California San Diego
Great location. Feel like they didnt justify 4 years. The simulation I watched on my interview was cringe worthy. There were R2's asking questions that made me want to jump out of the nearest window. They just talked up the location the whole time and I got the vibe they didn't want to work hard. (but hey, it's on my list because of location so who am I to judge).

Could happily train here, but not gonna put higher. Also, surgery experience was too odd.


16) University of Chicago Medicine
Don't wanna live in Chicago. Don't wanna go through growing pains of a new ED and everyone figuring out the trauma experience etc.

No doubt this is a great program and will continue to be a powerhouse, just not for me. This is far down mainly for personal reasons.


17) Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
I hate LA traffic with a burning passion. I spent more time on that trip in traffic than I did in classes my M2 year. Holy **** that Ronald Reagan campus is fancy. I felt underdressed in my suit. Just not my kinda people or vibe I want at all. Different strokes...

I accepted and went to this early, otherwise I would have cancelled.



Applied to: 48 programs. Way too many in hindsight, but got scared by advisor


Invited to interview, but declined: Denver, UCLA Harbor, Hennepin, Mayo, Carolinas, Virginia, Alabama, Henry Ford, Wisconsin, Michigan Ann Arbor, UT Austin.

 

[surely]

Applicant Summary:
Step 1: 240s , Step 2: 240s
EM rotation grades: Honors / Pass
Inducted into Alpha Omega Alpha: No
Medical school region: Southwest
Anything else that made you more competitive?: Nontraditional student, various work with free clinic and legislative action, very good FPS gamer

Main Considerations in Creating this ROL: family considerations, gut feeling, academics

1) CO -- Denver Health
+: Best overall fit for my family. As far as the program goes, I love the attitude of the residents and attendings at both UCH and DH, and got to know a few well during my rotation. They are all aware of the "malignant" reputation on SDN, but that's definitely not the case.
Some of the closest attending-resident comradery I've seen. Probably the best diversity of patient exposure of places I've interviewed with about equal split between safety net hospital and tertiary/quaternary center, plus nice Kaiser community experience in PGY3-4. Graduated responsibility, but are encouraged to push yourself. Residents see a lot of patients per hour. Multiple academic tracks. Close to family. Can't beat the outdoor experience for days off. Sets me up best for an academic career or community setting.

-Circadian scheduling (day --> evening --> night) is a little difficult and makes "days off" tough to enjoy. 21 8h shifts per month all 4 years (not a negative for me, but I know some people care about that stuff)



2) IL -- John H. Stroger, Jr. Hospital of Cook County
+ Amazing primarily county experience, with academic affiliation with multiple Chicago med schools. Most laid back residents and attending staff that I met. Very high acuity patients with a primarily underserved and immigrant background, which I really like. Most diverse residents and attending staff. Meal money $$$. 2 CTA trains close to the hospital. Good peds exposure at Lurie and Comer. Trauma is crazy. Multiple academic tracks. Lots of amenities in the city, so would definitely offer my family an opportunity to escape the grind on days off.

-Cold, so that would make outdoor activities during the winter a bit of a drag. 2 IM + 1 ID off service month intern year. Stroger in-house peds is not the best. Nursing seemed a little burnt out


3) IL -- Rush University Medical Center
+ Large academic/community hospital. Beautiful ED. Ever increasing volume (I believe grew 10k year over year to now 80k/yr). New program, but I do find the opportunity to build another great Chicago EM program enticing. Tertiary care center that has hosted County residents for a long time, so attendings are used to teaching residents. Trauma at Stroger for 4wks all 3 years. Loved the enthusiasm from the residency leadership during interview day and they emphasized the support they have from hospital admin and other in-house programs. Leadership listens to resident feedback and has already added 2 additional sites and altered OB and ortho rotations based on that feedback.

-New program.


4) NY -- SUNY Downstate/Kings County Hospital
+ NYC. Great academic/county program in Brooklyn. Lots of immigrant patients. High patient volume and one of the few hospitals in NYC that sees a good amount of penetrating trauma. Great experience with the residents and with the leadership on interview day, and all made me feel like this would be a great fit. Mini-fellowships are a nice touch and the leadership is very focused on turning out great clinicians that can go anywhere. Heavy academic focus at both sites. All the amenities of NYC are a short subway ride away. Amazing food in Brooklyn. All of the cultural exposure you could ever want

-COL!!!! Obvious, but wow. Residents also mentioned nursing shortage has improved, but residents do still do IVs and such, which could get annoying when trying to move the department. Lots of time on translator phones with mostly Haitian-Creole speaking patients, so even my elementary Spanish will be of little use


5) FL -- University of South Florida
+ Single site, but serves safety net patients as well as well-insured and tertiary patients. Good academic focus, especially US and EMS. Resident wellness focus is very obvious. Residents emphasized how close they are with all faculty (one resident felt very supported when multiple faculty offered to help him and his family out when the hurricane damaged his roof). Multiple wellness events hosted throughout the year at various sites in Tampa and at attending houses. Beautiful city with even more beautiful beaches in nearby St Petersburg. COL is dirt cheap compared to other areas I've lived.

-Seems a bit cush. Worried about alumni network being primarily in FL (?), as I'm not sure if that's where I want to end up for the long term


6) NY -- New York-Presbyterian - Queens
+ NYC. Very high volume with very sick patients. They really talked up their ICU admit rate, which, to the degree you believe those kinds of things, was much higher than anywhere else I interviewed. Really good interactions with PD and APDs and felt like we were a good fit. Residents are very close and have Wednesday afternoons off (Wellness Wednesdays) so they go out often. Perks of NYC as mentioned previously. Trauma month at Ryder in Miami 2nd year

- Cornell affiliation in name only, which is a bit of a bummer with my plans to be involved in education in the future. Teaching exposure is therefore not the greatest. The hospital was the most difficult to get to by MTA of all of my NYC interviews. Residents are a little too bro-y for me and where I'm at in my life. Only 1 Ryder month, otherwise mostly blunt trauma. COL


7) NY -- New York Methodist Hospital
+ High volume community hospital in beautiful Park Slope. Trauma at nearby Brookdale. All the city amenities as mentioned previously. Loved my interactions with residents. They are doing some cool innovative stuff with ECMO in resus situations, and they are very strong in US fellowships

- Hate to say it, but this was the biggest letdown. Just did not vibe with any of the leadership. They get almost no away rotators and spent a good while griping about the VSAS listing for their program. The whole day seemed like a bit too aggressive of a sales pitch, and a bit disorganized at that. COL in Park Slope is obnoxious even on attending salary. Would be a big QOL downgrade for my family. Trauma seems lacking, and it's tough to buy that Brookdale is an adequate solution when Kings County is down the street and NYC not seeing much penetrating in general


8) FL -- University of Central Florida/HCA GME Consortium of Greater Orlando
+ Enthusiastic leadership with a very aggressive approach to bringing their new program up quickly. Primarily hispanic underserved patients in Kissimmee. Pretty much the only residency in house, so all procedures are there for the taking. Warm all year. Leadership responsive to resident feedback and curriculum change requests. COL is dirt cheap

- City was a big letdown. Seems like, outside of Disney, there isn't much to do, as most residents answered something along the lines of "go to Disney" when I asked what they do outside of the hosptial. Otherwise Orlando seems like a big strip mall. New program. HCA--my wife is a RN and confirms a lot of horror stories that have been told on SDN. Not sure how that will play out with resident graduates, but it's disconcerting


Anything else to add?
That P on my 2nd EM rotation likely hurt me, but still got a good spread of programs that I'm overall happy with.


Rejected by:
LAC (waitlist), UW (waitlist), Northwestern, Christ, U Chicago, Vanderbilt, Brown, HAEMR, OHSU, Georgetown, George Washington, New Mexico, Penn, Temple, among others....

 

[doggydog]

13) Geisinger Medical Center
Second year resident said that she had yet to do a central line or an a-line.

This can't be true.

 

[gamerEMdoc]

This can't be true.

I was surprised by this as well. I just can't see how that could happen.

 

[surely]

Submitted anonymously via Google Form.

Step 1: 220s , Step 2: 220s
EM rotation grades: Pass / Honors / Honors /
Inducted into Alpha Omega Alpha: No
Medical school region: Southeast
Anything else that made you more competitive?: Not really...just average. Also a DO. Top 1/3 and middle 1/3 SLOEs.

Main Considerations in Creating this ROL:
Location, program culture, perceived "fit" are the main three. No interest in academics/fellowships. Obviously everybody likes 9s >10s >12s, but I'm willing to compromise on that for other factors.

1) MI -- St. John Macomb-Oakland Hospital
Former AOA program now in the ACGME. It is now a 3 year program. This program is technically one "hospital system" but it's two hospitals - St. John Macomb (Warren, MI) and St. John Oakland (Madison Heights, MI). Oakland is about ~50k annual volume and a little bit slower-paced. Macomb is ~90k volume and more or less a mad house. Interns do their first 4 ER months at Oakland before they can go to Macomb. Oakland is a more immigrant-heavy population while Macomb is older, with mostly working class white patients.

I'm ranking this program #1 because I felt it was the best fit as far as culture and how I fit in with the residents. You get as much variety and pathology exposure as you will at any other high-volume ED system. It's also my ideal location, since most of my friends and family live in either Macomb or Oakland county.

CONS: Interns do 12s.


2) St. Mary Mercy Hospital - Livonia, MI

Another former AOA program, remaining 4 years. ED months are 17 9s for interns, which is great. Livonia is a very old patient population, and the program puts a big emphasis on critical care. The hospital and the ED are really nice, clearly a lot of money going into facilities here. It seems to me you 'll get a lot of critical elderly patients and less of the crazy overdose/trauma/whatever stuff you would see in a less suburban/retiree-heavy location. Residents seemed really happy. Didactics were organized with faculty lecturers.

CONS: 4 years, not the most diverse patient population.


3) Henry Ford Allegiance Hospital - Jackson, MI

Former AOA program, remaining 4 years. Jackson has plenty of crime, right down to the "gun and knife club" you've probably heard about 50 times on your interviews. You'd think a national weapons enthusiast group like that would be more careful with handling them.

Anyway, it's a diverse patient population with lots of poor and under/uninsured patients. Allegiance is pretty much the only game in town, with UM Hospitals in Ann Arbor about 40 minutes away. That's a lot for one hospital in a metro area of about 150,000. Overall I liked what I saw, and it's still in the region I want to stay in.

CONS: 4 years. It's in Jackson, a city which has been bucking the improving economic trends in Michigan of the past 10 years by getting significantly worse in just about every metric. Ann Arbor is an acceptable commute, but still over 30 minutes.


4) RI -- UNECOM - Kent Hospital
Former AOA program, staying 4 years. Warwick patient population is old and blue collar, but you will do out rotations around Providence area. They do an OB ER rotation at Women & Infants Hospital, which you won't see at most other places. You can also score some neat away rotations like burn trauma at MGH as a senior. Shift length is 9s, I don't remember how many shifts but I think it was 17 or 18.

I had a great interview day here and a great rapport with the PD. I felt really comfortable around the residents. While I really enjoyed my visit to Rhode Island, it gets bumped down a bit due to my location preference.

CONS: 4 years, same narrow patient profile as St. Mary Mercy, far from home


5) MI -- MSUCOM/Mercy Health Muskegon
Former AOA program, remaining 4 years. Muskegon is a rough city. They have a very active chapter of that mysterious Gun & Knife Club™ I keep hearing about. The main hospital, Hackley, is literally on the boundary into Muskegon Heights, which has a high level of gang activity, and they get a lot of walk-ins with penetrating trauma. Neat! Fortunately or unfortunately, the two-campus system will be condensed into one campus at the current Mercy Hospital. There are a ton of opportunities for lucrative moonlighting in west Michigan as a senior, helping take the sting off that fourth year of resident's salary.

Cons: 4 years. Muskegon is a little too rough to live in. Nearly all the residents live in surrounding cities, including Grand Rapids and the nearby resort-type towns on the lake, but it's kind of a boring place to live overall. In-state, but west Michigan might as well be a totally different state.


6) PA -- Drexel University - Philadelphia
Drexel is one of the original EM programs, at an academic hospital in the middle of a huge city with a ton of resources and support. I have no idea how I got an interview here, quite frankly. It was my first time in Philly and I loved it.

Fit with the residents and faculty was excellent. They are very ICU-heavy here and have a resident-run ICU at one of the hospitals they rotate at.

CONS: The ED scheduling. You have 24 day blocks of 6 on, 2 off. 10 hour shifts at 2 of the 3 hospitals they rotate at, 12s at another. The 6 on progresses 2 days, 2 afternoons, 2 nights, 2 off, so realistically you get 1.5 days off per 8 days. Proportionately,this is the equivalent of 23 shifts per month. I also don't think 2 days is really enough to properly adjust a circadian rhythm anyway, so I don't see the supposed benefits to it, either.


7) FL -- Florida Hospital Medical Center Orlando
This is de facto my home program - not directly affiliated with my school, but located at the hospital I did my cores at. 12s, 18/17/16 if I recall correctly. I saw some nasty stuff being said about this program on SDN a while back, and I will say I don't really agree. There were definitely a couple of faculty that I genuinely didn't like, but only one that I saw residents have an issue with. That's probably pretty normal for most programs. Didactics were the best organized that I attended, with faculty regularly present. The PD and senior faculty are very committed to teaching and the residents are happy.

Florida Hospital East is located in the (duh) east side of Orlando, which is very poor to working-class with a large Puerto Rican population. Lots of Spanish, lots of uninsured, lots of drug overdoses. Trauma months are done in Ocala. ICU/PICU/etc. are done 20 minutes away at the main Florida Hospital South campus, which is a 1,200 bed juggernaut in a posh neighborhood. Doctors lounge is near the ED and always serves breakfast and lunch, with a Starbucks coffee machine (these things are important).

CONS: Program culture wasn't my favorite. Their disciplinary approach to certain things being turned in late or left undone was punishing you with extra ED shifts. I don't need to be threatened like a junior high school kid. I'm a big boy! In all honestly though, those things are pretty minor. The real con is that I don't want to move back to Florida for any length of time.



Anything else to add?
Wow, finally a below average applicant with a below average number of ranks! So brave!

Applied to:
Lol. I applied to 90.

Rejected by:
Too many.

 

[surely]

Submitted anonymously via Google Form.

Step 1: 250s , Step 2: 270s
EM rotation grades: Honors / Honors
Inducted into Alpha Omega Alpha: Yes
Medical school region: Midwest
Anything else that made you more competitive?:

Main Considerations in Creating this ROL: Fit and location, 3>4. Strongly believe that all the programs I interviewed at will provide great training and enjoyed all the places I visited, so focused a lot on what I thought of the locations and residents.

1) NM -- University of New Mexico
+ Academic program with a county vibe. Huge critical care focus (5 ICU months with the largest EM/CC faculty in the country), super sick patients, PD is heavily committed to social issues unique to NM. Recent ECMO and ECPR implementation, dedicated Ultrasonographer to teach, meal stipend, super cheap parking, Diploma in Mountain Medicine program. Cheap cost of living, very dog friendly, great food and beer. Great amount of penetrating trauma and cool ED resuscitation unit, great weather with lots of sunshine without being too hot. Fun faculty with diverse research interests. Great social mission, great outdoors, and great combined medicine-outdoor opportunities with the opportunity to go into critical care.

-Problems with hospital overcrowding leads to lots of boarding in ED, high property crime in the city. Not a huge name in EM, but grads seem to get good jobs


2) CO -- Denver Health
+ easily one of the best programs in the country in terms of job placement and clinical training. county patients at DH but also super academic patients at the university, resident ski lodge, wilderness med track available. Beautiful city with good access to mountains, cool outdoorsy residents.

-: Very intense schedule with many circadian flips, very expensive with bad traffic (especially I-70 on ski weekends), rotate at multiple sites. Extra year is hard to justify, but I would love to live in Denver and have the flexibility coming out of residency DH would provide


3) UT -- University of Utah Hospital & Clinics
+absolutely incredible outdoors access coupled with medically complex patients, young fun faculty and active residents, strong off-service rotations provide good ICU exposure and enough volume to see rarer stuff. Fun PD.

-acuity and volume are relatively low, don’t run trauma at university site, not as many ICU months, antiquated liquor laws, not very diverse of a city


4) CA -- University of California Davis
+great trail network inside city, new CC fellowship on the horizon, great proximity (2 hours to Tahoe, Bay Area, Yosemite), very affordable city allows for nice housing and dogs, most residents bike to work, great weather, great PD and I really liked the chief who led our tour!

-Just didn’t get the best vibe here. Nothing wrong with it, but nothing particularly great either.


5) AZ -- Maricopa Medical Center
+ sick underserved county patients, electives all 3 years, 5 ICU months including very popular burn ICU, residents seemed outdoorsy with 3 hours to J tree and 2 hours to Flagstaff, residents also very tight-knit, no ortho or optho residents to compete with, beautiful winter weather and lots of sunshine

-HOT, only one of 9 level one trauma centers in the area, sprawling city with bad traffic, merging with Creighton might change something in the program besides just the name


6) OR -- Oregon Health and Science University
+ One of the oldest EM programs with great job placement, very cool PD who values resident wellness. Beautiful trail network near hospital, aerial tram with bike valet on commute to hospital, beautiful facilities, huge beer city, Get paid $1/day to bike to work.

- RAINY AND GRAY, not the best penetrating trauma, current culture leads to long time spent charting after each shift, expensive. Least amount of deodorant per capita of any city during interview season.
If the weather was better, this would be much higher up.


7) WA -- University of Washington Emergency Medicine Residency Program
+Very happy close-knit residents, trendy city with great outdoor access. HUUUGE catchment area
!

-4 years in a super expensive city, lots of other specialties around, 12 hour trauma shifts, traffic. I would have to get a SAD lamp to live here. City consumed in constant debate with Portland on which city gets more rain. Rubbed the wrong way during a couple of my interviews


8) NC -- Carolinas Medical Center
+ one of the strongest 3 year programs in the country with extensive job placement network, single campus sees huge volume, lots of $$$ in program provides cool perks to residents, Whitewater Center nearby looks fun
!

-: Month of OB, peds floor, Community-ish program doesn’t give me the social mission of more county-oriented programs. Slightly lacking in outdoor activities, I’m not sure about living close to the South


9) KS -- University of Kansas School of Medicine
+really fun residents and faculty, low cost of living, bbq, good U/S exposure

-Patient acuity lower than many other programs, poor outdoor opportunities


Anything else to add?
Applied to 30, got interviews from around 22, only went on 9 interviews to save money and give spots to others (cancelled the others at least 3 weeks in advance). Had to nitpick to rank them all because I truly enjoyed the residents I met along the way and would be happy to match anywhere on my list.


Rejected by:
Vanderbilt, UCSF, UC Fresno, Tucson (both)

Invited to interview, but declined:
Hennepin, Stanford, Loma Linda, Henry Ford, Maine, University of Wisconsin Madison, Duke, North Carolina, University of Nevada Las Vegas, Cook County, Wake Forest, West Virginia, UT Austin, University of Missouri Kansas City

 

[surely]

Submitted anonymously via Google Form.
Step 1: 260s , Step 2: 260s
EM rotation grades: Honors / Honors
Inducted into Alpha Omega Alpha: No
Medical school region: East coast
Anything else that made you more competitive?: Was told I had great SLOE's? Also have been told I interview well, but who knows.

Main Considerations in Creating this ROL: 4 year = 3 year. Probably want to be in academics. Otherwise just looking for good people!

1) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
They really had the whole package for me. The resources and opportunities were immediately obvious, but I was really excited to see that the residents were all super normal/down to earth. Training at MGH is stellar, with every kind of pathology coming through the doors, and BWH serves to make sure you can handle the super complex patients that you wouldn't get at a community ED. Overall just a really good feeling and was so glad they lived up to what others told me about the program.


2) RI -- Brown University
Was really close to ranking this place #1. So much happening at Brown and its one of the busiest ED's in the nation too. 100+ faculty with all kinds of cool interests/niches. PD came across as super supportive and bubbly and someone you'd just love to be friends with. Residents were all friendly and over all I have nothing negative to say about Brown other than that Providence is small and isn't ideal if you want either city life or warm weather.


3) TN -- Vanderbilt University
3 year program that maintains great academic options if you're into that. Slovis is incredible and the PD, while new to the job, was super friendly and easy to talk to. Nashville is booming and growing and would be a great southern city to live in, with excellent COL given how much there is to do there. Honestly can't give you a reason why I liked my number 1 or 2 more than this program, just gut feeling, but I would be ecstatic to match here.


4) CT -- Yale New Haven Medical Center
Vast range of pathologies all under one roof. Great name as an institution if that matters to you. New Haven is just okay; not my ideal place to live but I could manage. PD gave a great presentation and I liked everyone I met, residents included. The way they run traumas is great, with EM splitting with surgery based on time of day. Again, they are number 4 because I have basically nothing negative but my gut pushed me to my numbers 1-3 more.


5) PA -- Hospital of University of Pennsylvania
Okay, if this place had a stronger name in EM, it would be my number 1. I don't get why it seems that they aren't more connected in the EM world. Tons of stuff going on here, ED environment was great, with everyone seeming super happy to be there and friendly, etc. Philly is underrated: tons going on without the grimy feel of NYC. Didn't leave with as much of feel of what the PD is like but that may just have been me. If you're into Peds, CHOP is amazing. Would be totally happy if this is where I match.


6) IL -- McGaw Medical Center of Northwestern University
Tons of bells and whistles and clearly a lot of money. PD sold the 4th year very well (as others have said) and they put on the best pre interview dinner of any program I visited. Chair is high up in the hospital which helps the EM department out. I think they dropped on my list because I wasn't a huge fan of Chicago.


7) OH -- University of Cincinnati College of Medicine
You could definitely feel their pride. Chair gave an insanely impressive speech. I left sort of feeling like I couldn't explain why they are so esteemed other than because they're the first program and have a great flight program. The city is just okay, but does seem like it's on the up and up. Clinical training is obviously excellent.
Didn't really jive with the residents at the pre interview social.


8) MI -- University of Michigan
Only reason this is so low is because of how cold it is in Ann Arbor and how far it is from my friends on the East Coast. Their biggest selling point to me was the EC3 ("ICU" in the ED), and if you're into flying this is a great place too. Had a great time at the pre interview dinner with the residents as well. Just not a huge fan of the location.


9) NC -- University of North Carolina
Had a great interview day here. Residents were all very cool and I liked the mix of training sites between UNC and Raleigh. Great weather and friendly people. There was a good mix of residents in that some were interested in academics and others wanted community jobs. Overall just liked my 1 - 8 more.


10) IL -- University of Chicago Medicine
Gorgeous new ED and trauma center. PD is amazing and I'm not the first to say it. Didn't meet a ton of residents but that's my own fault (travel issues) so I bet I would have liked this place more if that hadn't been an issue. Felt far less academic than Northwestern, despite the institution name. Supposed to be the busiest trauma center in Chicago when they open, which was appealing, but overall nothing else blew me away here.


11) DC -- Georgetown University Hospital/Washington Hospital Center
I absolutely LOVED DC. Great city and COL is comparable with Boston and Chicago. PD and residents both great. 3 years and still plenty of good academic opportunities. I just felt like they were still a relatively young program and WHC felt a little run down.


12) GA -- Emory University School of Medicine
I know they're a great program but I didn't like Atlanta and didn't meet any residents I really liked. Grady is obviously a wild place to train (a plus for me) but it didn't outweigh my feelings about the location and one or two odd interactions with some residents.


13) IN -- Indiana University School of Medicine
The weird interview questions they're known for aren't a huge deal, it's just that by the end of the day you walk away feeling like you never got to sit down and just have a normal/fun conversation with anyone, and I'd probably have left with a better gut feeling if I'd had that opportunity. I will say the pre-interview dinner was a blast, but that wasn't enough to make up for it. I know they're considered an amazing program and I was impressed with the training sites, but I went in already hesitating about the location and the weird questions didn't help.


14) PA -- University of Pittsburgh Medical Center
Great reputation, but it seems like it's really only their EMS and critical care that make them so great, neither of which I'm super passionate about. Pittsburgh has a good COL and enough to do but is cold and far from friends/family for me.


15) NY -- SUNY Downstate/Kings County Hospital
Heavy county feel (blessing and a curse) with residents who are probably a bit overworked. Not in love with Brooklyn but I'd make it work. Nothing really sold me on their 4th year.


16) MO -- Washington University St. Louis/Barnes-Jewish Hospital
As cool as the PD was, the residents who gave my tour were kind of weird and so were the other applicants (though I guess that isn't Wash U's fault). St. Louis not my ideal location for sure.

 

[AlgernonMed]

This can't be true.

I was surprised by this as well. I just can't see how that could happen.

Submitted anonymously via Google Form.

13) Geisinger Medical Center
Didn't vibe with the facutly here well. Was asked over and over again about where I was interviewing. PD had nothing but negative things to say about everything I said in the interview. Second year resident said that she had yet to do a central line or an a-line

I interviewed there and didn't get this impression at all. The PD was one of the more friendly and conversational directors I met and the residents seemed more than capable and confident. Maybe you didn't sleep well the night before or ate too much at the pre-interview dinner....mmm chocolate Oreo cake....

 

[surely]

Submitted by @EmergencyApplicant554 via Google Form.
Step 1: 200s , Step 2: 250s
EM rotation grades: Honors / Honors / Honors
Inducted into Alpha Omega Alpha: No
Medical school region: Northeast
Anything else that made you more competitive?: I have really amazing reviews.

Main Considerations in Creating this ROL: Location, shift length, good life for my kids and partner

1) CT -- Yale New Haven Medical Center
I came in expecting not to like Yale, since I did medical school in a county hospital. However, I loved the mix of hospital patients, that we're the only game in town and the schedule. I didn't like the prehospital dinner, but I had non stop laughter during the resident lunch and had amazing conversations with the APDs. The name brand doesn't hurt. The location is also perfect for us to buy a house and for my SO to find work.


2) NY -- State University of New York - Stony Brook
Also a surprise. Big names in EM, lots of cool critical care stuff, 3 years, good place for my kids. Good schedule and nice area.


3) MA -- Boston Medical Center
Very similar to my medical school. Not a flashy residency but had a great time hanging out with the residents. Loved the PD! Boston Medical Center is legendary, county hospital with awesome support. Would be #1 if a 2 bedroom wasn't so damn expensive. I do appreciate that the hospital acts as a guarantor, but when I did the math it was just too costly.


4) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
My home hospital. Wouldn't have to move, would be #1 if it wasnt for 12 hour shifts


5) NY -- Hofstra Northwell SOM at North Shore / LIJ
Liked the residents. $$$$ nice area for my family


6) MA -- Baystate Medical Center
Would be #1 if it wasn't in Springfield. Loved the residents, lots of families, really smart residents, beautiful hospitals, my favorite PD of them all. It was heartbreaking to rank this low, but low pay and bad location for my SO made this a no go.


7) MA -- University of Massachusetts
Worcester is um.


8) NY -- Mount Sinai St. Luke's Roosevelt Hospital Center
Recent resident suicide gave me pause. Don't want to raise kids in manhattan.


9) NY -- SUNY Downstate/Kings County Hospital
Loved the residents so ****ing much, but too rough to live and work at brooklyn


10) NY -- NYU/Bellevue Medical Center
Rotated there...no thanks


11) CT -- University of Connecticut
Seems like an easy residency. Good place for my SO and kids, but I was just lukewarm on this residency


12) NY -- New York Methodist Hospital
Don't think this is family friendly


13) NY -- Albany Medical Center
Not diverse enough, coming from county I can't imagine it. The PD was great and wellness was amazing. Overheard a disturbing conversation by residents that just soured me on the whole program enough to mentally rank them last before I even left the building.

 

[surely]

Submitted anonymously via Google Form.
Step 1: 200s , Step 2: 220s
EM rotation grades: PassFail Only / Honors / Honors /
Inducted into Alpha Omega Alpha: No
Medical school region:
Anything else that made you more competitive?: 1st author on published EM research paper, poster presentations at national conferences.

Main Considerations in Creating this ROL:
Patient population diversity, Location, Significant Other input (non-medical career)
Had to attend quite a few interviews due to low board scores.

1) TX -- UT Southwestern Medical Center - Dallas
Pros: High volume, high acuity county population. Resources of an academic powerhouse. AMAZING facilities. Great off service rotations. And Children's Hospital of Dallas next door for an elite PEMs experience. APD and PD both women and were very supportive and friendly. Resident class is ~20ish and they were all awesome in the preinterview dinner. Dallas is a solid city with major sports scene and solid night life. Cheap COL relative to other cities.

Cons: Because they have a great IM, OB/Gyn, Surgery departments and bc the volume can get insane some residents seemed to consult out procedures that EM should handle at most places. Spoke with a resident and he said this is very resident dependent and you can do your own procedures (reductions etc.) if you like but have the luxury of consulting. Their months at Harris (community hospital) seemed to take care of any shortcomings in the procedure numbers. They are the only physicians in house. Terrible food benefits! Residents said they get like no $.

Shift # intern year varies depending on mix of 11's and 12's. The +1 or 2 indicate time to wrap up your work and not be accepting new patients.
10+1s/8+2s/8+2s


2) IL -- University of Illinois Hospital - Chicago
Pros: 4 main sites to practice at, and therefore a nice variety in patient population and pathology. Also the variety in training sites allows you to figure out what practice environment and patient population you may want to work with. Trauma experience is at Advocate Christ during second year. Nice residency size (15) and were hands down the best residents on the trail. Dr. Snow (APD was probably one of the coolest guys I've met on the trail). Big alumni network and therefore not relegated to only working in Chicago post residency. Committed to improving program evidenced by a new academic track (social service track) they created for this year to integrate. To me they offer these cool tracks that I've mostly seen in 4 year programs and therefore you get an opportunity to explore a niche. Awesome public transportation. I loved this program as much as my #1 but in the end my SO job situation would be better at my #1 ranked program.

Cons: Residents say that intern year is the hardest not only bc of the usual difficulties of intern year but bc they switch sites every month so they have to get used to new system, new ancillary staff, new attendings etc. They say they do not really get to know faculty outside of the core faculty from UIH until PGY2 year. That being said I think the benefits of multiple sites outweigh the negatives. Cold af in the winter but eh thats why winter gear was invented.

Shifts: 18 x10


3) IL -- Rush University Medical Center
Pros: Very nice facilities and a committed leadership to making this a great EM program. Rush already has other established residency programs which makes for nice off service rotations. Trauma/SICU @ Cook county. Awesome community experiences at Rush Copley. PD emailed applicants of two additional hospitals to get more trauma and community experience (further evidence of constantly looking to improve). Emailed a resident and their work life balance is great (their ED months they work an avg of 45-50 hour work weeks). Chicago as a city is amazing (night life, culture, cuisine, music festivals, public transportation). Attendings are used to teaching Cook residents therefore having residents around is not new to them.

Cons: New program and therefore no alumni network. Growing pains of a new program. Unsure of how that would impact job prospects down the road if you did not want to stay in Chicago. Cold af in Chicago. Although this is a new program, I'm confident it will be an attractive program after they graduate a couple classes. Rush as an institution has solid national reputation.

Shift: 8+1 on weekdays and 12's on the weekends. You work 2 weekends per month and get 2 full golden weekends per month


4) FL -- University of Florida - Jacksonville
Pros: High volume county with high acuity, level 1 trauma center. EM run hospital, AWESOME nurses and staff. Traumas shared with surgery, half of the body to EM and EM always gets airways. They have critical care patients in a separate area in the ED. You walk in and this place looks like some chaos with beds all over the place, a true county feel. Residents were very cool. They have their "baptism by fire" mantra and all the residents I met seemed to know their stuff very well. APD Dr. Morrissey is who I want to be when I grow up. That guy was awesome. As an intern you have all medical airways and serve as junior resident in their different pods (fast track and critical care pod). As a PGY2 you get all TRAUMA airways and all critical care resuscitations (trauma and medical). As a PGY3 you basically have preattending duties and you have junior residents reporting to you and med students.

Cons: Jacksonville as a city is ok. It is oddly split into quadrants with a river running down the middle of it. The freeway to the hospital is also 2 lanes which makes it a pain in the butt as far as traffic during rush hours. Hospital needs to technologically upgrade... I'm shocked they have an EMR (they still have a grease board... come on guys lets get an electronic tracking board). IM like sign outs at the beginning and end of shifts...

Shift: It's a **** ton like 21? Downsides are that they do a full signout at the beginning of shifts and at the end.


5) IN -- Indiana University School of Medicine
Pros: Residents got along well and incorporated spouses, mentioned spouses come even when resident spouse not there. Big alumni network and older prestigious program, great prep for fellowship and can pretty much move anywhere post residency. Very nice facilities, great benefits with all dependents covered. Low cost of living (1 br luxurious ~1200), cheap houses. Moonlighting PGY2 & 3. Little traffic. All the prestige of a 4 year program squeezed into 3. Residents say that they grow up during the ICU rotations as they are THE senior residents.

Cons: No community EM rotations. ICU heavy, include PICU, PICU/NICU rotations. Not sure about Indianapolis (residents selling points were Indy 500 and state fair... meh).


9 hour shifts 18-20/ 17-19/16-18


6) TX -- University of Texas Health Science Center School of Medicine at San Antonio
Pros: an up and coming program. Dr. Muck was probably the coolest PD I met on the trail. He did a lot of cleaning up when he took over as far as bringing in new faculty. He has made great strides in the turf battle vs surgery and now EM handles the airways (according to a resident). Great patient population diversity and pathology (major tertiary referral center for South Texas). They work with the military a lot in this airway course to prep their medics. Program kind of small with 10 residents but they were very cool and laid back, seems like they incorporate spouses well. COL is low and facilities were above avg. No outright educational stipend but Dr. Muck said if you need it they usually get it. Newer program in TX (established in 2006) but has graduated a few classes now.

Cons: Not a huge fan of San Antonio. NO EPIC (they run something else). Peds experience seems decent at best (they stopped really rotating at Children’s Hospital of San Antonio but believe you can do electives there). Still a dicey but improving relationship with trauma surgery.


7) NY -- SUNY Downstate/Kings County Hospital
Pros: Trauma 1 COUNTY, busy hospital. Big creole population. Salary around 68K according to resident. Brooklyn is an awesome city, just really liked the vibe of it. Big class size. Residents seemed close to each other (although they had a poor turnout to my preinterview dinner). A large percentage of their class does fellowships. They have tracks that you can explore different niches. Committed to diversity, a very ethnically diverse group of residents!

Cons: 4 year program . Facilities were very county looking and old. Nurses union forces ppl to put in their own IV's, push patients etc. PD seemed really cold during the interview... like no smile. But residents say she isn't mean and really goes to bat for you. NO EPIC. If this was a 3 year program... it would definitely be in the running for my #1.


8) AR -- University of Arkansas
Pros: Great leadership, Eastin among the coolest PDs. Only level 1 trauma center in State and next door to only level 1 peds trauma center in Children’s hospital of Arkansas. Shared ownership was preached between residents and faculty. Good amount of brewery game with low cost of living. Great significant other involvement (rivaled only by Indiana). Established yet young enough program for change.

Cons: Little Rock... it's just not my type of city. Would not be bummed out if I match here bc the program is awesome and everyone keeps saying it grows on you.


9) NY -- Hofstra Northwell School of Medicine at Staten Island University Hospital
Pros: Great patient cultural diversity, only hospital in Staten Island. Very energetic PD. Recently expanded to 10 residents. Community and academic sites. Train majority of time at one facility, two facilities in total. Highest salary of NY programs. Possible to live at tip of manhattan or south Brooklyn. Can take the ferry from manhattan for free! Runs every 15 min usually. COL in Staten Island is also a lot cheaper than NYC. Staten I close enough to NYC to get all the benefits but far away enough to have enough space to drive your car and have a house.

Cons: Probably not as much reputation as some of the other NYC programs but definitely a solid program. The resident class size was really small at 8 but we got an email during the season that in 2018 they will have 10 residents.


10) TX -- Texas Tech Health Science Center/Paul L Foster School of Medicine
Pros: Really the only major academic center this far west in TX. They get a lot of border pathology. Patient population very diverse. Most amazing sim facility I saw on the trail (yes even compared to Rush). COL is very cheap. Lot of outdoor activities for ppl to do. Surprisingly very safe city even though it's next to the border. Great Mexican food! Facilities were nice. Able to drive and plenty of money for food at the hospital.

Cons: El Paso is not my ideal location but I love the patient population they offered. Salary is relatively low... high 40's. Didn't really connect with the residents. Their PD seems absent. They told us the APD runs the program and the PD is kind of behind the scenes? Peds exposure didn't seem as strong as other programs.

Shifts: I know they do only 12's.


11) NJ -- Rutgers New Jersey Medical School
Pros: Solid group of residents who were very funny. 10 residents per program and pretty diverse bunch. Connected really well with them during the preinterview dinner and they had a huge turnout. Great leadership, Dr. Sule (PD) was very chill and the Chair is really involved and trying to improve that program. We had an actual interview with the chair too. Good preparation for fellowship training and flexibility with electives, there are different tracks.

Cons: Facilities were meh, pretty avg county facilities, peds experience decent at best. Jersey has a cheaper COL than NYC but still not my ideal location.


12) FL -- Florida Atlantic University
Pros: PD was a really nice guy and preaches work life balance. Very impressive timeline of scholarly projects outlined for residents. Very receptive to resident feedback and gave examples of what he changed for their trauma rotation (they were going over work hour limits). Seems like a nice new program that has solid leadership and on the rise. Boynton beach is a nice area in FL.

Cons: Resident class size is 6. PD has no plans to expand, as he says he likes small intimate class sizes. I personally just want a bigger program but nothing wrong with smaller program sizes.


13) FL -- Kendall Regional Medical Center
Pros: Emphasize clinical learning and business side of things. PD was former PD at Penn State and seemed to have a solid vision for the program. New program but will be complete set of residents with my class, good resident quality. EM not overshadowed, procedures for days. Big educational stipend, unlimited food. Nice facilities, for profit hospital. Nice sim center. Kendall/Miami area is nice. The core faculty was great and connected well with them during interviews.

Cons: Parking! They just got a new permit for a garage but it won't be complete until about a year or two into residency. Right now ppl park on the street or some other lot like 15 min away that you have to take a shuttle to the hospital from there. Traffic in the AM is ridiculous (was almost late for the interview!). Salary was only 50K in a city with high COL. NO EPIC. HCA run -_-. Probably the best of the HCA run residencies at the moment.


14) WellStar Kennestone Regional Med Ctr (Marietta, GA):

Pros: Stroke Center, cath lab, hospital system is established and seems like faculty were eager to teach. Dr. Stettner (PD) was APD at Emory before. Facilities were very nice. Peds experience within the WellStar system is decent. Had the feel of an academic community hospital. A lot of the trauma from northern Atlanta go to WellStar. Probably good educational experience since other residency programs are very new. IM and OB/Gyn in like their 2nd year (so not fighting people for procedures). Marietta is a nice suburb of Atlanta. It is about 30 miles from ATL.

Cons: Brand spanking new program. Dr. Stettner did not exactly lay out a firm vision. Medicine floor month . Growing pains of being the very first class of a new program.


15) NY -- University at Buffalo - SUNY Buffalo
Pros: New hospitals including brand new Peds hospital. Major tertiary center in upstate NY. Different track programs w/in 3 years; favorite one is PEM’s track, especially with the brand new children's hospital. Helicopter air service incorporated into curriculum. Fellowships in EMS, US, PEMs. Preach a lot of diversity and inclusion. Residency class size is at 16. They seemed like a laid back group of people.

Cons: Buffalo


16) FL -- University of Central Florida at Ocala
Pros: Great benefits (food, educational stipend). Cheap cost of living. Quality of life is great, 45 hour weeks intern year on EM months. PD used to be PD at a couple of places and has good experience in shaping young programs. Community hospital that gets a lot of geriatric population. Has other residency programs but did not seem to take procedures from EM.

Cons: Big questions as to their OB/Gyn experience and PEMs experience. Seems like they would do those at different hospitals but not sure if it was hammered out yet. Residents currently there were outside the match last year but were cool guys. GUYS ONLY lol hopefully they get some ladies in their class this year. Small community ED, NO EPIC. Unsure about direction of program, future fellowship opportunities. New program, Level II trauma center, HCA!


Applied to:
about 70 (low board scores)

Rejected by:
too many to name

Invited to interview, but declined:
Southern Illinois University

 

[surely]

Submitted anonymously via Google Form.

Step 1: 260s , Step 2: 260s
EM rotation grades: Honors / Pass / High Pass /
Inducted into Alpha Omega Alpha: Yes
Medical school region: Midwest
Anything else that made you more competitive?: Really strong MSPE comments. School has a strong rep in the Midwest for good EM candidates.

Main Considerations in Creating this ROL:
Fit (whether residents seemed fun and happy, if I had a good time at the social), location (closer to home was better), strong trauma/peds because those are my favorites. At the beginning of interview season, pictured myself in an urban county program that emphasized helping the community. During interviews, also fell in love with academic programs and got really interested in flight medicine and EMS.

1) MI -- Wayne State University Detroit Receiving Hospital
This was the program that had everything I want. A busy no-frills county feel with a stellar reputation in the city for high acuity patients and lots of trauma. Really strong peds exposure being the only program in Detroit that routinely works at Children's. Everyone in the program was invested in the city, which was important to me. Residents described work as "fun" and clearly were a tight-knit group with a vibrant social life outside work. Close to family. Bonus: flight time at Umich! Bottom line: connected with the residents, faculty and city and walked away from the interview blown away.


2) MI -- University of Michigan
Went here for undergrad so drank the koolaid about leaders and the best for sure! So many resources that could certainly turn anyone into a national player in academic Emergency Medicine. Really strong critical care and flight medicine. Lots of opportunities for EMS and event medicine at the Big House. Only 4 year I interviewed at and was not a deal-breaker for me because I love the city and liked the concept of developing a niche and becoming a leader. Did a second-look and saw some very high acuity medicine patients and a packed ED. Mott Children's is amazing. Everyone in that hospital is a genius and would teach me so much. Cons: limited undifferentiated trauma or county exposure. Was concerned about being able to get a job in a county environment if that was what I eventually wanted.


3) IL -- University of Illinois Hospital - Chicago
Really loved the 4 different hospitals as I'm familiar with the city and know how much each one has to offer and how broad and diverse the education would be when they are all put together. Really clicked with the residents and faculty. They are clearly a funny group that enjoys their work and Chicago! Emphasized both wellness and community outreach, both of which I'm excited about. Plus Christ for trauma is unparalleled.
Cons: I would prefer some time in a peds hospital, wasn't sure if I wanted to train in Chicago and would like the option to fly.


4) MI -- Henry Ford Hospital
Very strong program in Detroit with an amazing critical care education. People here are committed to taking care of Detroiters and were some of the most hard-working, empathetic and bad-ass residents and faculty I have ever seen. They definitely work hard, but are prepared for anything. As far as fit, felt like the program was more serious/academic/nose to the grindstone. Definitely has a national reputation. Cons: not as strong in Peds, not the greatest work-life balance.


5) WI -- University of Wisconsin
If this program was closer to family, it would be a contender for number 1 on my list. Absolutely loved the PD and chair (girl power! We talked a lot about female leadership). They have a really strong flight program and a big, amazing pediatric hospital. While low on penetrating trauma, residents emphasized lots of drunk driving blunt trauma and farm accidents. Really liked the 3+1 concept. This program's resources and academic opportunities completely made me reconsider going into academic Emergency Medicine. Plus Madison is a gorgeous place to live and work and the residents couldn't stop raving about it. Cons: similar to UMich in lack of penetrating trauma, less diverse patient population and limited county experience. Plus far away from family.


6) MI -- Sinai-Grace Hospital
Was very impressed with this program. Definitely the ultimate county experience. You do literally everything, including all ortho and trauma, since EMS takes most trauma patients here regardless of Level 2 status (but also you do a lot of IVs and nursing/tech work). They see incredibly sick patients and the worst trauma in the city. Clicked with most of the faculty as they too are trauma geeks, and the PD really is a cool guy. People who work here clearly are passionate about the community and caring for a very disadvantaged and sick population. Cons: They are very open about their nursing shortage and the tension that causes, and relationships with nurses and ancillary staff are very important to me. I also felt like while I would love the trauma experience here, I wasn't sure if I wanted this level of autonomy and limited resources in my training. The lowest number of residents at both the social and interview day and they looked exhausted.


7) OH -- Case Western Reserve University/Metro Health Medical Center
Really liked the emphasis on time spent in a county hospital with some time spent at Cleveland Clinic to see the weird academic stuff. Emphasized flight medicine and were clearly strong in EMS/disaster medicine. The program actually makes efforts to make residency less painful/more fun with scheduled days with the whole class or whole residency off, and the residents clearly took advantage of that time to have fun together. Seemed like a really fun group. Cons: not the biggest fan of Cleveland. Would like more emphasis on pediatrics.


8) MI -- St John Hospital & Medical Center
Really liked the PD and the faculty that I interviewed with. They really felt like a family and seemed to genuinely care about each other as a group. Another interesting patient population, with half of patients from Detroit and the other half from Grosse Pointe. They see lots of children and trauma. Cons: Hands down my least favorite curriculum. So many inpatient floor months and outpatient experiences, way too little ED time. Old-school didactics. If they updated their curriculum they would be much higher!


9) OH -- Mercy St. Vincent Medical Center
A solid program that I would be happy matching at. Great flight experience and a county environment. Awesome faculty and residents. They are always updating their curriculum and have a lot of innovative simulation ideas. Cons: Not the best at U/S. Was not a fan of blocks of all day or night shifts. I have family in Toledo but it's a pretty small city and I would rather live elsewhere, though it is very affordable!


10) IL -- Presence Resurrection Medical Center
Clearly a strong program with a ton of autonomy, lots of procedures, a really strong ultrasound program and some interesting patient populations they take care of. There are definitely some pros to training at a community hospital where you run the ICUs and handle high acuity patients solo. Cons: The commute with this hospital being so close to O'Hare would be absolutely brutal. Didn't click with the residents. They emphasized a level of autonomy that others might think is awesome but would be too much for me personally.


11) MI -- Western Michigan University Homer Stryker MD School of Medicine
Really awesome flight and ground EMS experiences. I absolutely love the idea of being sent into the field as a resident. Their two main hospitals are a great split between community and county feels. Huge sim lab and clearly tons of resources with Stryker. Solid program that would give you great training. Cons: Just really didn't connect with the residents and faculty. Not interested in living in Kalamazoo. Overall not for me.


12) IL -- Rush University Medical Center
New program that knew how to sell it. Goal of becoming the strongest EM program in Chicago in 5 years, which is pretty ambitious. Lots of resources and lofty goals. Trauma at Cook would be cool. Cons: not the greatest opportunities for pediatric experiences. Might be silly but they were the only program I interviewed at that didn't give us breakfast and I spent the entire day starving, which negatively colored the day. Definitely didn't connect with my interviewers. Just not a great personality fit for me.



Anything else to add?
Got a surprise pretty bad SLOE from a strong Midwest program that I had thought would be my number 1. Clearly wasn't a great fit but took me out of the running from some cool places.



Rejected by:
Cook County, UChicago, Northwestern, Advocate Christ, MCW, Indiana, Cincinnati, Beaumont, University of Toledo, Case Western UH

Invited to interview, but declined:
Central Michigan, St. John Macomb-Oakland

 

[gamerEMdoc]

I interviewed there and didn't get this impression at all. The PD was one of the more friendly and conversational directors I met and the residents seemed more than capable and confident. Maybe you didn't sleep well the night before or ate too much at the pre-interview dinner....mmm chocolate Oreo cake....

The PD there is an excellent educator. Everyone has bad interview days I guess, even programs.

 

[theWUbear]

Minor corrections from above rank lists: Robert wood johnson is a 3 year program (it was said to be 4 above); florida hospital orlando doesn't come to ocala for trauma (although UCF North Florida does)

 

[Bill Brasky]

Minor corrections from above rank lists: Robert wood johnson is a 3 year program (it was said to be 4 above); florida hospital orlando doesn't come to ocala for trauma (although UCF North Florida does)

Should be Lakeland, not Ocala.

 

[surely]

Submitted anonymously via Google Form.

Step 1: 240s , Step 2: 260s
EM rotation grades: High Pass / High Pass / High Pass /
Inducted into Alpha Omega Alpha: No
Medical school region: Northeast
Anything else that made you more competitive?: Well rounded app, 2nd quartile with Hs in Med/Peds/Surgery, fun hobbies, no H's SLOEs (rotations actually stuck to only 10% Honors), but I think I was ranked top 10% for the "how highly will you rank this candidate". Pretty chill person, interview well I've been told (SVI 23 if that meant anything?).

Main Considerations in Creating this ROL:
Location (weather, beaches, nature, and/or cool city) > fit = quality of training. 3 years >>>>> 4 years. Very blessed to have received invites I did, hoping for somewhere warm, but Chicago, D.C., and NYC are great too.

Most likely going community (considering fellowship) with a small desire to teach residents at some point. Thus I want as much experience with procedures/autonomy while still learning to be very efficient. Did not apply to 4 year programs/withdrew from the few I did.

1) CA -- University of California Irvine Medical Center
Pros: 70 degrees year round? 20 minutes from the beach? Sign me up! Mostly happy residents (a few looked tired/out of it), fun focus on med-ed and things like active quizzes/games during conference. Know I would get great ultrasound training here. Very busy, lots of autonomy, mix of county/academic/community. Multiple rotation sites. Really liked one of the interns who I spoke with at the dinner. PD and coordinator were great, don’t recall any of the other attendings (aside from Fox obviously).

Cons: They are worked hard on shift, very busy. They say it’s a weakness and a strength. I’m not sure how much busier they are than other places and I couldn’t get a PPH from them because they just switched, but it seems like a pro/con. The area is very commercial and built up which I don’t really like. You can live in Long Beach which would be sick, but I would rather be able to bike to work every day.

Favorite thing(s): Just overall great California vibe, young and fun leadership, can live the beach life!


2) FL -- Orlando Regional Medical Center
Pros: Happiest residents and super chill place. Got a great feel from here, really hope to open the envelope and see Orlando Health. Goodbye winters! Hello healthy living! I feel like this place had the most well rounded training of anywhere I went (tied with EVMS). Great trauma, critical care, pediatrics, and OB. This hospital is the hub for a wide radius so they get to see it all (even with the other residencies, this place is the best!) Relatively cheaper COL. Paper charts apparently make their charting time almost non-existent which I like, but my handwriting is so bad I wonder if this would slow me down… Probably a plus and a minus. Beach is an hour away which you can actually use year round. Schedule has improved from previous years, still fairly intense. Can bike to the hospital from a sweet downtown high rise apartment, but biking in May-September might be rough with the heat. Lots of free food!

Cons: Orlando FL has a lot to offer besides theme parks (although I do love those and would go all the freaking time), but might not be my favorite place? No friends/family here. 18 12s 1st year. Hot, humid summers (but you can have a pool easily!) Paper charts will be transitioned to electronic in 2 years so senior year we would have to switch.

Favorite thing(s): Happy people, true family feel in and out of the hospital, great weather year-round!


3) IL -- University of Illinois Hospital - Chicago
Pros: Love Chicago, great people, sarcastic, easy going, and smart. Lots of site variety so early exposure to multiple practice environments, I do enjoy driving and it’s a good time to listen to podcasts and such, but I would prefer a place that I could bike to easily. Hours seem very fair, decent benefits. Overall very well rounded training. Had several advisers who have been involved in Chicago EM for decades say they think it's the best program in Chicago.

Cons: Chicago is great… but those darn winters! Not much nature nearby, especially in winter. COL is pretty high if you want a nice apartment. Commuting to multiple sites can be annoying, but most aren’t that far away and your home base (UIC) can be easily reached if you live in West Loop.

Favorite thing(s): Chicago is my favorite big city, well-rounded training, chill people!


4) SC -- Medical College of South Carolina
This is for MUSC, Charleston SC which didn't seem to be listed here.

Pros: Charleston is Charleston. Beautiful place, warm most of the year, beach is 20 minutes away. People were nice. Residents seemed happy. Training seemed good. That was all I needed to see to rank it top 3.

Cons: Seems like procedures, ortho, and trauma were all limited. Don’t know if I want to live in this “Southern” of a state. I’m not into college football and that’s 80% of what was discussed at the resident dinner.

Favorite thing(s): Charleston, weather, beach!


5) DC -- Georgetown University Hospital/Washington Hospital Center
Pros: Got a great feel, have friends/family in DC, emphasized peds/trauma/crit care. Know an attending from here who couldn’t recommend it more highly. Just didn’t get as good of a feel as top 4. Expensive, but can get a sweet apartment for much cheaper than NYC and you can keep your car. I like the 2 hospital system (plus a few other sites you rotate at, including Shock Trauma!).

Cons: Didn’t feel overly special or excited about here, just pretty good. Some residents seemed tired or not overly enthused about being there. Winters are rough. Summers are hot. Lots of commuting as well. 22/21/20 shifts per calendar month, kind of a lot.

Favorite thing(s): Friends here, well-rounded, cutting edge of Health Policy!


6) FL -- University of South Florida
Pros: Warm, near the beach (surprisingly far away from what I envisioned, like 50 minutes with little traffic. New PD is great overall and she improved the hours significantly with a better focus on wellness. Seems like pretty solid EM training with exposure to all different parts.

Cons: Residents did not seem very enthused about this place, they all kind of looked tired. Except one resident on the interview day lunch (they take you out for lunch which was a very nice touch and relaxing) who was a really charismatic and fun guy. I’ve heard mixed reviews about this place, Tampa downtown area wasn’t my favorite either. Peds seemed lacking due to some issues with the Children’s Hospital nearby and not being able to rotate there, although they are trying to change that now. PD was really intense in the interview. I've heard she's nice and I tried to relate a funny story but she was all game face.

Favorite thing(s): Weather, beach, hospital overlooks the water!


7) IL -- Presence Resurrection Medical Center
Pros: Chill people, good sick patient population with above average procedures. Chicago (ish, north chicago). Friends in the city, good benefits, possibly best schedule besides Rush (15 12s and 17 10s for most/all rotations? Aside from some ICU/trauma.) Gelled with the PD and interviewers.

Cons: If you want to live in Chicago proper you’re stuck with 30-60 minute commutes for 3 years. Really want to avoid commuting that much if possible vs. UIC where you can live in Chicago and bike to all your UIC rotations and commute to the others. Again, not a ton of nature, winters suck. Still very happy here!

Favorite thing(s): Chicago, awesome schedule, great community training!


8) NY -- Mount Sinai St. Luke's Roosevelt Hospital Center
Great reputation, big alumni network, good focus on wellness. Very smart, friendly attendings who like to teach. Shadowed in the ED and saw some crazy things. Definitely seems like they get you being autonomous very early. Have friends in NYC, would be a cool experience.

Cons: Everyone else seemed to love this program but I didn’t get a super special vibe by any means. Expensive COL for everyday things. I really want to keep my car and that is basically not feasible here. Didn’t fall head over heels in love for resident housing like many of them have/did/are (and they’re bumping the price significantly this year, or were trying to last I heard (December)). I don’t know, I just didn’t click or feel it. Central Park is great but it seems harder to escape into nature here than other places. Decent beaches are far away. Cold winters.

Favorite thing(s): Family feel, NYC, friends!



9) VA -- Eastern Virginia Medical School
Loved this place. Was #1 for a while. Norfolk was not quite the best place for us, otherwise would be strong contender for #1. Hidden gem if I’ve ever heard of one. Very chill, nice, and smart attendings. Rotate at a community site for a few shifts each ED month where it’s just you and ED attending running the traumas. First years off-service are all M-F 9-5 (except trauma). No ortho or anesthesia residencies. People complain about traffic here but compared to LA/NYC/Chicago it’s nothing. Great pre-interview dinner at a resident apartment lounge, catered food and brought in beer, much more of a relaxed feel.

Cons: Less vacation time? 15 days (3 weeks), but they do send 1st years to SAEM and I think 3rd years to ACEP. And you get 3-4 days off during Holidays. Still, I would rather have more days off laid out. 21/20/19 shifts per 28 day month. 8+1 hours. It’s about the median for hours/month, but I feel like I might prefer a few more days off for an extra hour or two per shift. Senior resident (who I believe worked a different schedule throughout (they were 23/22/21) said they felt like it was ok. They were happy going to 85% of their shifts at this point. Just not as much love for this program by the residents.

Favorite thing(s): Beach, awesome training, chill people!


10) FL -- Jackson Memorial Hospital
Pros: Warm, fun, new! Miami! Residents were cool, PD was super approachable and friendly. Seems like solid training, busy hospital.

Cons: Do not love the “Miami scene” of partying/flaunting money (I know this isn’t all of Miami). I do not speak Spanish fluently and ~80% are Spanish speaking. I wish I spoke Spanish and this would definitely force me to learn, but I’d rather not have to focus on that too during residency. Commute to Ft. Lauderdale 25% of the time and it’s 45 min - 1 hour away. Some of the interviewers were a little dry. Too much eye candy, a random nurse on campus was seriously hotter than Megan Fox. I actually looked around for cameras because I assumed they were filming some medical movie/tv show. They were not. Also my uber driver ripped me off, claimed I damaged their car and charged 40 extra dollars. Felt like a typical thing to happen in Miami.

Favorite thing(s): Weather, beach, training, learning Spanish!


11) CA -- Riverside Community Hospital / University of California Riverside
Pros: Loved this place! It seems like they have the tools to give you great training, I should have shadowed in the ED to get a feel for the place. One intern had 60+ intubations 4 months in. Basically unopposed residency (although multiple new programs are in the works to start soon including ortho and anesthesia). Good benefits. California + warm is always nice, although it can be hot and smoggy in the Inland Empire. It was one of my first interviews but I got one of the best gut feelings from here. PD seems like a stand up guy, very pro-resident. Would be totally happy here and still want to move this up higher. Beach an hour away.

Cons: Hot, smoggy, not a ton of great apartment buildings, not a big downtown area (although Riverside does have a cute downtown area, just not big enough for me). No reputation, no alumni, might not be able to get that fancy SDG job with this rep, at least without working somewhere else first. Mostly just didn't enjoy Riverside area enough, no ties here. 22 shifts / calendar month.

Favorite thing(s): Autonomy, PD, procedures, California!


12) IL -- Rush University Medical Center
The attendings here are young, smart, and eager to teach. PD and APD are very pro resident and willing to change anything for the good of the program and its people. 2 new rotation sites that will increase exposure to trauma and other procedures is really awesome (in addition to trauma at Cook). Most rotations at Rush, a few outside, so not as much commuting as the other sites and you get to live in the West Loop which would be legit. Best schedule I've seen (2 golden weekends every EM month plus not a ton of shifts overall ((could be a con too?))

Cons - I’ve heard they consult a ton. Saw ENT down to sew up an ear lac that looks like it would have been very educational for a resident. Newer program, but solid in other areas and that wasn’t really a concern. Chicago is great, but cold. Have I emphasized that enough? Not enough nature/outdoors stuff year round. Yeah ice skating is fun, but not for 6 months. Want more hiking, year round beach, or something else. UIC/Pres offered more overall which is why they were higher.

Favorite thing(s): Chicago, West Loop, great schedule, cool faculty!


13) FL -- University of Florida - Jacksonville
Pros: County and autonomy. Busy busy. Solid training, lots of procedures. Beach is 20 minutes away, no more winters.

Cons: Residents looked overworked, didn’t seem crazy enthused. Although a friend rotated here and she really enjoyed her month (perhaps didn’t get beat down that badly and living it every day is different). Problems with psych bouncebacks. The residents being less than enthusiastic and super tired appearing made it last, but honestly I would be happy here, it’s just something had to be near the bottom.

Favorite thing(s): Beach, weather, autonomy, COL!


14) TX -- CHRISTUS Health / Texas A&M
Pros: Really liked this place, got such a chill vibe from everyone. Love the beach. Autonomy is insane, only EM and FM in hospital. Great procedures and experience. Again, I would be happy here, just something had to be last on the list.

Cons: Too small/sleepy of a town, felt surprisingly unsafe despite such a small town. Want to work in Texas later, would rather go somewhere else for residency.

Favorite thing(s): Beach, autonomy, weather, COL!




Anything else to add?
I over-applied (better safe than sorry) and withdrew from places as soon as I had enough interviews. It really felt like a shot in the dark in terms of who invited me and who didn't. I went into my EM rotations pretty burnt out so I didn't prepare as much as I should have. Thus, even on my 2nd rotation I had a syncope patient and thought "Hmm what else do I need to r/o for syncope? I can't remember syncope work-up since IM", rather than knowing my stuff better and having a solid plan for every patient. I was just so burnt out from 3rd year and step 2 and wanted to learn on the job, which I did, but given you do so few shifts that even on the 2nd rotation I hadn't seen a lot.

I would prefer my top 3, but matching at any of these places would be wonderful and there are great things about each of them.


Withdrew from before hearing anything:
Jefferson, Temple, UMass, Rochester, Utah, V. Tech, U of C, Palmetto, Advocate Christ, Virginia Tech, Duke, Loma Linda, Kaiser San Diego, UCSD (didn't want 4 years), UCSF (didn't want 4 years), Austin, Maryland (waitlisted), Wake Forest, VCU, Christiana

Rejected by:
Maine, OHSU, Emory, CMC, UC Davis, UNC, Beth Israel, All Arizonas

Invited to interview, but declined:
Einstein Philly (4 years all 12s?), Stony Brook, Hofstra, UT Murfreesboro, Myrtle Beach, Brooklyn Methodist, Greenville SC, ECU

 

[surely]

Submitted anonymously via Google Form.

COMLEX Level 1: 635, Level 2 >735
Step 1: 230s , Step 2: 250s
EM rotation grades: Honors / Honors / Honors / Honors
Inducted into Alpha Omega Alpha: No
Medical school region: Southeast
Anything else that made you more competitive?: Somewhat unique non-medical extracurricular activities that were brought up in every interview, more than just 'tell me about xyz thing you do' if that makes sense. SLOEs were brought up multiple times as being strong.

Main Considerations in Creating this ROL: SO is already in residency, location (proximity and overall live-ability), fit, 3 years > 4 years, always-ACGME > newly-ACGME/formerly-AOA, rotation at multiple different sites, ease of access to good biking and running

1) WI -- University of Wisconsin
Pros: best residents I’ve encountered, Madison is a kickass city, awesome program leadership, great on-shift teaching, multiple sites, “pre-attending” shifts at the community ED during third year, ample opportunities for medical student education, solid flight program, program has solid outside funding for “extra stuff.” The area has really strong primary care, so generally, the patients who come to the ED have genuine problems that need addressing. Strong process to review each rotation throughout the year and make changes to things that aren’t as beneficial for the residents. The best overall vibe from anywhere I went. Strong personal ties to the area/program. Madison is a very young, active-lifestyle-friendly place to live. Home of an Ironman and a college town, making pedestrian and bike traffic expected and respected (plus some of the best biking I’ve ever experienced.) Relatively cheap cost of living.

Cons: limited trauma (especially penetrating), not a crazy busy ED (but good volume), at the upper end of number of shifts per block at places I interviewed – although the shifts are a good length, a little more “hand holding” than other places (but definitely get more freedom after intern year, as you do at many programs), didn’t love the didactic set up- it’s the more traditional lecture set up instead of the flipped classroom/EM foundations. The food scene is a bit lackluster.


2) WI -- Medical College of Wisconsin
Pros: Awesome trauma setup. ED is arranged so that you never have a more senior resident covering the same rooms (but medically ill patients are distributed evenly among them. Don’t have to see fast track patients (but have some fast track shifts to still get that exposure.) Might sound goofy, but the time blocks of the shifts are really nice. Personally, I really like Wauwatosa/Milwaukee. Cheap cost of living. Good didactic set up. Free parking.

Cons: Less heavy on-shift teaching. More patients who use the ED for primary care issues.


3) IL -- University of Illinois Hospital - Chicago
Pros: This program is doing some awesome community outreach stuff. Good mix of sites (academic, county, community) so great variety of patients. Really great vibe from residents. Solid trauma experience. Chicago as a city is awesome, aside from the driving/parking part (see comment below)

Cons: I despise Chicago traffic. Hate it. Having to drive to all the different sites might kind of suck. Relatively higher cost of living.


4) IL -- University of Illinois College of Medicine/St. Francis Medical Center at Peoria
Pros: Amazing program. Loved it. The attendings are all really chill, down-to-earth. Residents are great as well. Lots of independence. FREE. FOOD. Good free food. Grocery-shop-worthy food. 24 hour cafeteria. I eat a lot so this is a big deal. Free parking. Dirt cheap cost of living. Fantastic didactics. Program leadership is awesome. This was one of my audition rotations, and it was probably my favorite (most freedom.) Academic-level facilities/specialists in a community setting, which I personally like. Multiple training sites. Insane simulation center (not the biggest deal to me since I’m not a crazy sim person but still nice.) Pod system set up is kind of neat.

Cons: It’s Peoria. Not the most awesome location in the world. Would be higher if not for the location. A lot of psych holds that stay in the department due to placement issues (a problem at other places as well, but seemed like it was worse here.) Lots of patients use ED for primary care/ things that don’t need to be seen in the ED. Limited outdoor (running/biking) opportunities, but a lot of the attendings and some residents are into outdoorsey stuff so there’s some stuff.


5) IL -- Rush University Medical Center
Pros: Multiple strong rotation sites. Solid residents. Good vibes. Program seems like they’ve got a good plan, and is quick to make changes based on resident feedback.

Cons: Would only be second class, but it’s attached to a well-established institution so that’s reassuring. Didactics sound a little lackluster. ICU rotation is “not for procedures” which is weird to me, but apparently people still really like the rotation.


6) IL -- Southern Illinois University
Pros: Can’t put my finger exactly on it, but got an awesome vibe here. Crazy into simulation stuff. Unique in that you rotate at two level-one trauma centers (one academic, one not.) Sounds like you get a good variability in attending teaching style (something important to me.)

Cons: Springfield is meh. Not the busiest of EDs. Newer program (newly going to be an independent and not under surgery)


7) IN -- Indiana University School of Medicine
Pros: Would be higher if it were closer to my people. I loved it here. One of the more “big name” programs on my list, which comes with the prestige and alumni network. Will be absolutely ready to take care of whatever comes through, seems like you get used to being totally slammed. Multiple solid training sites – one being the nicest hospital, county or otherwise, I’ve ever seen. Residents were awesome. Big emphasis on wellness. Indianapolis is the perfect size city in my opinion.

Cons: The graduated responsibility is a lot more rigid than other programs. Location is really the only reason this one dropped so low. You get worked real hard.


8) IA -- University of Iowa Hospital & Clinics
Pros: Wonderful people (faculty and residents.) I’m a fan of the college town vibe. Gorgeous ED with natural light, which is almost weird I’m so not used to it. Didactics are top notch.

Cons: Seemed like ED transfers were a significant chunk of the patients coming in, so you don’t have the chance to do the initial workup. Heavy on rural EM, which is not my deal.


9) MI -- St John Hospital & Medical Center
Pros: I feel like this is underrated/over-powered by other Detroit programs. Located at the intersection of very distinct patient populations, which means great patient variability. BUSY ED. Great trauma exposure. Lots of autonomy. Gorgeous newly renovated ED.

Cons: Lots of autonomy (on-shift teaching is not super strong. Notice this is a pro and a con for me) Only 3 EM months first year in addition to orientation month, one of which is PEM. Spend a lot of time doing US-guided IV starts since none of the nurses do them (odd thing to stick out, but it sounded like a big kink in resident workflow.) Don’t want to live in Detroit.


10) MI -- Michigan State University/Sparrow Hospital - Lansing
Pros: Solid community program. Being hooked up with the MSU statewide campus system is nice. Multiple sites. Guaranteed two weekends off a month on ED months. Cheap COL.

Cons: Just didn’t love it like I loved some other programs, didn’t get the best vibe. Still rotates at a hospital with paper charts (really nice for getting your documentation done quickly, but makes chart biopsy-ing a giant pain in the ass.) Lansing is a mediocre city at best.


11) MI -- Western Michigan University Homer Stryker MD School of Medicine
Pros: Ridiculous EMS experience. Two very strong, large hospitals with solid trauma exposure. Well-established and EM leadership has some significant leadership roles within the hospitals, making their voice heard. Dirt cheap COL.

Cons: Meh location. 21ish residents per class is way too big for me. The residents made it sound like it wasn’t exactly their first choice program but “it was alright,” which just didn’t sell it for me. One of the two most ridiculous interview experiences for me (insanely long day, weird behavioral questioning-style interview. Seemed more drawn out than it had to be.)


12) NC -- Wake Forest University
Pros: Loved it. Well established. Strong academics. Great residents. Some of the coolest applicants I met on the trail (says something about the type of people they attract as residents in my opinion.) Winston Salem is an awesome city. Cheap COL.

Cons: Distance from my people. Would be closer to the upper-middle of my list if it weren’t so far away.


13) KY -- University of Louisville
Pros: Awesome residents. Have heard (almost) nothing but positive things from people who have had more exposure to the program than I. Good mix of patients from a gigantic catchment area. Home of an Ironman, making it runner/biker-friendly with a good bit of outdoor activities to do. Mild winters.

Cons: I’m not into the amount of autonomy these residents are given. Seems like a great experience as an upper level resident since they do a large chunk of the staffing, but somewhat detrimental when you’re more green. Since I’m a fan of the stronger academic feel, I didn’t jive as well with this set up. Location is a bit far from where I’m trying to end up.


14) OH -- Doctors Hospital-Ohio Health
Pros: One of, if not the strongest osteopathic names out there. Columbus seems like a cool enough city. The external rotations are close to the core hospital for the most part. Strong clinical teaching.

Cons: Four year program. Smaller community setting; still get sick patients but lack some of the variability, and a lot of the more “academic” stuff goes nearby to Ohio State. Worst interview day of my bunch. Got a really weird vibe that the program was kind of full of themselves (I don’t know how to better explain it.) The opposite of a laid back experience both at the pre-interview dinner and during the interview day itself, which is so not my style. I feel like I got a lot of facts about the program, but I didn’t really get to know any of the residents/about the actual feel of the program which was a big turn off for me. Didactics are still a lot of long lectures.


15) MI -- Henry Ford Wyandotte Hospital
Pros: Chance to do trauma at Shock Trauma. Tons of procedures. Multiple rotation sites. Attendings were all super awesome; the residents were a solid bunch as well.

Cons: Stabilize and ship just about everything, so you get good at being the “tape and glue” guy, but not great at final dispos of the ultra-sick. Lots of traveling for rotations, you have to rotate at outside hospitals to meet requirements which is different than the multiple rotation sites at other programs on my list. Multiple comments about how I might have issues for being a woman in the program, which rubbed me the wrong way and seemed weird that it was brought up on multiple occasions. Seems like the training was lacking in ways I can’t really pinpoint, other than it being a smaller community program. Did not like the area at all.


16) St Mary Mercy - Livonia, MI

Pros: Family vibe- the residents seem close and like genuinely nice people.

Cons: Four years. Doesn’t seem like the strongest clinical training I could get. Lots of resident-run didactics. Don’t like the location. Not a huge fan of the primarily small, community setting (at least for training.) A lot of stabilize and ship. When discussing what the program was looking forward to improving, they mentioned multiple things that many of the other places I interviewed already have.


Anything else to add?
Since I am probably one of the very few people sharing rank lists with some of these programs, for the sake of future applicants looking at these programs, it might be worth mentioning that I am a DO applicant. For reference, I got >635 and >735 on level 1 and 2, respectively.

Since no one can stop me, and no one is forced to read this, I'm going to air my grievances: In my n=1 experience, being a DO with an otherwise solid application seems like it closed some doors all on its own. I've seen MDs with similar/lesser stats (i.e. who look similar on paper according to this spreadsheet- not that that's the whole story) get interviews at programs I would've killed for. I didn't apply to some programs that I would've liked to because I knew it was a waste of money based on the number of DOs they (don't) take. I kept some interviews at programs I was less psyched about because while I think I set myself up in a good position, you really never know. I feel almost silly with 16 ranks, but I felt like it would be best to keep some formerly-AOA programs in the mix because I am, at least on paper, a more competitive applicant on the DO side.

To DO students who are looking at this in the future (2019 specifically) and deciding which match to take part in, I would strongly urge you to apply heavy, if not entirely, on the ACGME side. There are so few AOA EM programs left that it is almost more competitive to stay on that side. There are tons of DO-friendly and formerly-AOA programs on the ACGME side now, with even more entering next year.


Applied to:
69. Too many to list.


Rejected by:
University of Michigan (waitlisted but never got off the wait list), Regions, University of Pittsburgh, Thomas Jefferson, Ohio State University Hospital, Presence Resurrection, Penn State, DMC Sinai-Grace, University of Chicago, Washington University St. Louis, University of Nebraska, Northwestern, Hennepin County, plus some silent rejections

Invited to interview, but declined:
University of Connecticut, Cooper, Cape Fear Valley, Memorial Health-Marietta, Albert Einstein, WellSpan York Hospital, University of Mississippi, Leigh Valley Health Network, Baystate, Henry Ford Macomb, St. Luke's, Genesys, University of Missouri Kansas City Truman Medical Center, Lakeland Health, St John Macomb-Oakland, University of Oklahoma- Tulsa, UPMC Hamot (Erie)

 

[surely]

Submitted anonymously via Google Form.

Step 1: 250s , Step 2: 270s
EM rotation grades: 2 rotations, both Pass/Fail only
Inducted into Alpha Omega Alpha: No
Medical school region: West coast
Anything else that made you more competitive?: ED scribing experience, leadership positions for med school interest groups, teaching positions in med school and in the community, LOR from well-known faculty

Main Considerations in Creating this ROL:
Warm weather, county programs, and Spanish-speaking patients were most important. Also somewhat cared about 3>4, large residency class sizes, and having minimal consultant presence in ED. I'm single and my family is out of state (where I didn't apply), so my support system is my med school friends and I'm looking for a similar dynamic in residency. Torn between wanting to live in a city for the music/beer/etc and living near mountains where I can backpack and ski. My program comments below are notes I took post-IV, so they omit well-known attributes and focus more on things I learned while on site.

1) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pros: awesome reputation and location, faculty are leaders in the field, strong disaster medicine, NICU rotation as R4, carry code bag for hospital, grateful patients, 1 week off together at end of intern year, big/lil sibs are paired into groups of 4 for mentorship, beautiful new ED
Cons: ortho downstairs often, no wilderness faculty, lots of off-service intern year


2) CA -- Los Angeles County/University of Southern California Medical Center
Pros: most impressive residents, great faculty, residents are respected throughout the hospital, lots of autonomy, carry code/airway bag for hospital, very grateful patients, direct admit privileges
Cons: 12s are rough although some shifts are transitioning to 8s and 10s, ortho often downstairs


3) CA -- University of California San Francisco/ Fresno
Pros: amazing wilderness medicine opportunities, big ED, 40% seen by APP/attending so residents see higher acuity, record resuscitations and review during conference, few consultants in ED, 4 weeks off after intern year (unpaid), wine country and farmers markets, R4s get scribes. They have 4 months of elective during R4 (called area of concentration) during which many help train medics in wilderness med, others have done event medicine, overall helps justify fourth year.
Cons: not crazy about Fresno. Love the relative proximity to Yosemite/SEKI but not sure if realistically I'll have time to do overnights during residency. Many residents are married with kids, not sure if this will make it hard for me to fit in being single.


4) AZ -- University of Arizona College of Medicine at South Campus
Pros: 9 hour shifts, no trauma surgery present for traumas at south campus, no graduated responsibility, interns get priority for procedures, hang out with UMC residents (15 per class), prioritize medical Spanish with classes every other week and pay for dual role provider certification, border crossers come here. I really vibed with these residents and Tucson. It was tough ranking a non brand name program this highly, but they send graduates to all the desirable west coast cities and I think I would be quite happy here.
Cons: lots of married residents, small class of 6 (although I noted above that they do work and spend time with the main campus residents), south campus is level 4, not much diversity among residents


5) LA -- Louisiana State University - New Orleans
Pros: always run traumas and split procedures/good relationship, PD solicits feedback from residents and wants you to find your passion within EM, grateful patients, Ceasefire program (violence prevention) and many other community outreach opportunities, festival every week often with free entry if you do some work. Originally had this lower on my list due to minimal Spanish speaking opportunities, but this city is crazy fun and has the most incredible music scene so I bumped it up.
Cons: finish logging procedures at beginning of third year (seemed a little later than other programs), anesthesia shows up to traumas, longish commutes to community hospitals, only $50/2 weeks for cafeteria. Brand new hospital feels like a hotel and the ED was very quiet which made me concerned about getting the county experience I'm looking for. Later on the trail I talked to residents and applicants who had rotated here, they said it is high volume and there is nothing to be concerned about in terms of clinical exposure and reputation.


6) CA -- Loma Linda University School of Medicine
Pros: EM gets half of all procedures including L thoracotomies (even/odd days), scribes starting intern year, very enjoyable residents and faculty, large class (15) and many single, can do 2 months international with salary/benefits, direct admit privileges, great sim center, didactics are interactive and small groups, when lectures happen they are TED style, some event medicine, 3 years
Cons: academic to county is 60/40, only 4 months of ED intern year, seems like fewer procedures than other places I’ve interviewed. As the season went on I found that academic programs did not fit my personality, however between how much I liked the people here and the strong training in 3 years I felt it deserved this spot.


7) CA -- Alameda Health System - Highland Hospital
Pros: lots of autonomy, close knit faculty/residents, GI rounds every shift, strong global health, 8 hour shifts
Cons: traumas run by surgery so you don't get longitudinal trauma exposure (an EM resident is on the trauma team), low threshold for trauma activation, small department (44 beds), the bay is too cold and gray for me with high COL and lots of traffic


8) CA -- Riverside Community Hospital / University of California Riverside
Pros: PD loves wellness and advocates for residents, high volume, lots of procedures, few residencies in other specialties, patients have labs done up front (pro and con), increase to 12-14 residents next cycle
Wellness: 2x Fri-Sun off every month, get fourth of July, Thanksgiving, Christmas eve/day, and New year’s off (possible because attendings run the ED), mini fellowship where you "follow your passion" and have one fewer shift per month, nights grouped together, all educational materials and licensing paid for, unlimited food, 10 hour shifts include 2 hours of charting time, retreat in spring, 40% discount at Hangar 18, free concierge service
Cons: most residents coupled up, officially ED/trauma split running traumas, ortho and gen surg start next year and may take procedures. I was tempted to rank this program more highly given all the incredible perks combined with strong training, but I just didn't vibe with the residents.


9) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Pros: funded international and tox rotations (can do international tox, some go to Antarctica for global health), 2 retreats per year in Palm Springs, lots of young attendings and fellows, time to moonlight internally R2.5 and externally R3, 4 months of elective, fun group of residents, great location.
Cons: mostly academic and community, 2 hour commutes to olive view during night shifts (carpool), night shifts not scheduled in a row but can trade to do in a row. I loved my interview day and had it ranked highly. Over the season various sources said the clinical exposure is not in line with what I'm looking for, which would be tough to stomach for 4 years.


10) CA -- Kaweah Delta Health Care District
Pros: strong training, little competition with other residencies, 3 years, community exposure prepares you well for attending life in terms of billing, metrics, patient satisfaction
Cons: anesthesia may take half of trauma airways starting next year, scut during surgery month, publication required, vacation is 4 x 1 week, 4 week orientation, mostly married or engaged, location not ideal, not much resident diversity


11) CA -- Kern Medical
Pros: tons of Spanish, tied with USC for my favorite residents, great pathology, don’t use consultants, blue collar feel, tied with Highland for #2 trauma volume in CA, do all nights in a row, conference 15 minute segments and can sub in Hippo EM questions,
Cons: Bakersfield, small ED, boarders up to 1 week, no set roles in trauma, no international support. This is another program that was high on my list until I was honest with myself about how much I could bear living in Bakersfield for 4 years.


12) FL -- University of Florida - Jacksonville
Pros: awesome clinical training, no graduated responsibility, 3 years, good COL
Cons: sign outs are an hour or longer, residents are possibly overworked, only 3 weeks of vacation, ortho is downstairs (but they added a month of ED ortho during R2), hurricanes. Mainly ranking this low due to location.


13) NV - University of Nevada Las Vegas
Pros: high volume, learn by doing (interns run codes), awesome event medicine, close to hiking/good food, longitudinal US/peds/EMS, direct admit privileges, sick kids because poor ambulatory services
Cons: work very hard, trauma does all level 1/2s
When I arrived at the social none of the residents introduced themselves for about 20 minutes. An applicant mentioned that the program is sometimes considered malignant and no one refuted; they said the department is busy so they sometimes don't have time to teach MS4s but they are working on it. During IV I brought up how the intern class is all male and the faculty member said the program works residents very hard and maybe female applicants aren't looking for that. I wanted to love this program, but this was too many red flags.



Withdrew from before hearing anything:
UCSF, Vandy, Stanford, Utah

Rejected by:
Carolinas, UC Davis, Kaiser SD, New Mexico, Emory, UNC, Austin, Denver, Maricopa, UC Irvine, UTSW

Invited to interview, but declined:
Orlando Regional, UCSD

 

[surely]

Submitted anonymously via Google Form.

Step 1: 210s , Step 2: 230s
EM rotation grades: Honors / Honors
Inducted into Alpha Omega Alpha: No
Medical school region: West coast
Anything else that made you more competitive?: Was told I had really strong SLOEs, one of which was from a well known EM institution. URM.

Main Considerations in Creating this ROL:
Location, fit, 3=4 as I'm planning on doing a fellowship if I match at a 3 year.

Tried to listen to hip hop from the area I was interviewing at, will keep the theme here for my list as a fun change to the same old ROL thread haha

1) CA -- Los Angeles County/University of Southern California Medical Center
"To live and die in LA, it's the place to be"

+Consider this the best training in the country, ED runs all trauma and does all procedures besides thoracotomy, Jail ED, residents are all incredible and super down to earth, amazing faculty, get to continue practicing my medical spanish

- 12 hour shifts all 4 years but I think this could be changing with the new PD coming in. LA traffic is insane.


2) CA -- University of California San Francisco/ Fresno
Didn't know any songs from a Fresno MC or group

+ Really thought the PD Dr. Sawtelle was awesome. Great group of residents who were amazingly thoughtful and sweet. Fresno is the only trauma one in like a 2.5-3 hour radius so they get a great mix of very interesting cases. Organophosphate poisoning to the GSW and everything in between. Loved the ParkMedic program. One month off at the end of intern year (albeit unpaid) is baller. Great CoL ,minimal traffic

- I have heard others say that living in Fresno was the only drawback, but for me personally, Fresno is my speed.


3) CA -- Alameda Health System - Highland Hospital
"I be more hipper than a hippopotamus, get in your head like a neurologist"

+ Got the vibe that everyone here was really cool. Sat in on a didactic session and it was great. Unionized residency with a housing stipend. Pretty good pay. Super interested in the peds experience at CHO and the community experience at Kaiser Richmond. The APD gave me the warm fuzzies when interviewing. Really awesome research potential with their social EM division

- COL in Oakland is getting pretty expensive.


4) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
"But I know what I'm doing, Out the window of the jet, you see L.A. like a Bruin"

+ Had the most memorable conversation of the interview trail here with the APD. Could genuinely tell that she was 100% committed to creating a place with amazing educational opportunities and a place that truly welcomed and valued diversity. She was truly awesome. The residents here were all very nice and down to earth. Great caliber off service rotation months. Can choose to do peds at any peds hospital that will take you on (i think some residents went to Boston Children's or Rady's in SD), very well known faculty, Olive View as a true county experience, Antelope Valley site seems amazing (ED residents pretty much doing every procedure that comes through the door in a very busy ED)

- Expensive to live on the west side, the 405 makes me cry


5) CA -- Riverside Community Hospital / University of California Riverside
Didn't know any Riverside lyrics references D:

+ Really great group of residents, very busy ED with very sick patients, not technically a county hospital but very much a county feel, really no other competing services so the ED residents get dibs on all procedures (in fact I think I remember the residents of the first year class have already completed all of their procedure numbers to graduate), free food (potentially losing tho), building a new gym across from hospital, PD is one of the biggest wellness advocates I've met and I truly appreciated how authentic he was.

- Newer program so less mentorship available from upperclassmen, it gets silly hot in Riverside


6) MN -- Hennepin County Medical Center
"Purple rain, purple rain"

+ This program had everything I was looking for. Amazing training, ED residents do everything here (including thoracotomies), 30 US machines including some really nice touch screen ones, residents were super awesome, also really loved talking to the APD here, this program was sitting at number one on my list for a very long time but I couldn't get the SO to sign off on it. Oh well. Nothing bad to say about this program, super baller


7) GA -- Emory University School of Medicine
" And when I'm on the microphone you best to wear your sweater
Cause I'm cooler than a polar bear's toenails"

+The most diverse program I interviewed at on the interview trail which was awesome, recently renovated ED which was really nice, PD was very kind, potential event medicine with the Falcons.

- Another place I couldn't get the SO to agree on lol


8) IL -- University of Chicago Medicine
"They said they need proof like a vestless chest
About the best-fed f-f jet in the nest
Who exudes confidence and, excess depth"

+ Awesome new trauma center is opening in may of 2018 in the area that is most hard hit by the gun violence in Chicago, Awesome flight opportunities here including scene call outs, and opportunities to medically escort international patients back to their home countries as a moonlighting opportunity, Comer's children hospital for peds experience is amazing, very diverse group of residents (And also super tall cohort of residents lol), brand new ED is gorgeous

- only negative for me is that its far away from family. Nothing bad to say about this program, absolutely awesome


9) IL -- John H. Stroger, Jr. Hospital of Cook County
"A psychic read my lifeline, told me in lifetime, that my name would help light up the Chicago skyline"

+Another awesome program, trauma experience probably second to none, diverse group of residents

- same as above


10) NY -- SUNY Downstate/Kings County Hospital
"Shout out to Nostrand Ave, Flushing Ave, Myrtle
All the County of Kings, may your ground stay fertile"

+ Another amazing county program with everything I was looking for, awesome group of residents, very diverse group of residents, working with a very sick patient population.

- Couldn't think of any negatives with the program. Just far away from family. Sorry got tired at the end hahaha.


Anything else to add?
I wanted to write this list to help encourage others who may have low board scores like mine to still try EM if that is their passion. Really try to rock those Sub-Is. Getting strong SLOEs will really help. Also if you can, find a great faculty adviser that can help you navigate the process. Don't give up


Rejected by:
UCLA Harbor, Denver, Baylor, Cincy

Invited to interview, but declined:
LSU NO, Jacobi, WashU, MCG, Stony Brook, Hofstra, Cooper, Einstein, Christiana, Indy

 

[surely]

Submitted anonymously via Google Form.

Step 1: 260s , Step 2: 270s
EM rotation grades: Honors / Honors / Honors
Inducted into Alpha Omega Alpha: Yes
Medical school region: Southeast
Anything else that made you more competitive?: AOA, GHHS, 3x Top 10% SLOE, #1 class rank. ED scribe in past. Interesting journey to get into medical school.

Main Considerations in Creating this ROL: Planning on Tox, so programs with either an in-house fellowship or a strong tox exposure.

I prefer multi-site residencies with a solid academic/county split - county settings provide fantastic training, but I want to learn from the best-of-the-best on my off-service rotations, which is harder to come by outside of the ivory tower.

FOAMed that residents are involved in producing is a plus. No real preference re: 4 vs. 3. Highly prioritize programs that value resident wellness and work/life balance. I'd like to avoid 12s as much as possible. In terms of location, close to mountains & ocean is ideal. Thankfully, my partner and I have similar preferences.

1) CA -- University of California San Francisco - San Francisco General Hospital
Pro: Nearly ideal blend of quaternary care academic EM at UCSF and county medicine at SFGH. UCSF is a world-class health sciences institution and has many resources available to residents. Ideal location, I love the Bay Area. In-house tox fellowship. Good fit with the pleasantly geeky - but still sociable - residents (including one with their own FOAMed blog).

Con: COL, COL, COL. UCSF is a household name in medicine but less so to the lay public.


2) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
Pro: As the PD says, their priority is producing "badass" doctors who do more than just attend in the ED. Harvard is the world-leading university, with universal prestige and name recognition. Just recruited several leaders in the tox field (including the person who built Toxikon), who are all at the stage of their careers when they are eager to take on mentees. Residents extremely impressive and storied, with strong FOAMed presence.

Con: No true county experience. I liked Boston, but less so than SF. Tom Brady sucks. No tox fellowship or inpatient service yet, so I would have a more difficult time evaluating "a day in the life" of a tox fellow and the day-to-day of toxicology as a career.


3) MA -- Harvard Affiliated Emergency Medicine Residency at Beth Israel Deaconess
Pro: Variety of clinical sites with very high acuity at BIDMC. In-house tox fellowship. Slightly more gritty than MGH/BWH but still with that shiny HAEMR name. Love that 3+1 with a truly optional 4th year.

Con: I got the feeling it was less academically oriented than my top two. Somewhat plays second fiddle to MGH/BWH. Many community sites, so felt a bit fractured.


4) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Pro: Great academic/county split. Very intense clinical training at Olive View, with high acuity and procedural volume. UCLA truly prioritizes resident wellness as an institution. Felt good "fit" at interview day and dinner.

Con: No inhouse tox. Commute between the two sites is brutal. Works mostly 12s as a way to minimize time sitting in traffic, although residents preferred this system to working more 8s. SoCal is less appealing to me than NorCal and my partner doesn't love LA.


5) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pro: The most academic of the historic county programs, with dedicated teaching rounds at beginning and end of shift. Faculty very involved with research. County medicine makes for some well-trained and well-equipped graduating doctors. Works 9s, with reasonably good hours throughout.

Con: Weaker off-service rotations at Harbor. Single-site training. Less tox connections and no fellowship.


6) CA -- Los Angeles County/University of Southern California Medical Center
Pro: Initially, I had this program towards the bottom of my list, given the extreme hour burden and both residents and faculty warning me that I would have to put most other aspects of my life on the back burner during residency. However, they appear to have re-structured their shifts and hours slightly with the new PD, so it might not be as bad as it appeared. Residents were the most clinically impressive of any I met on the trail. Historic mission and training.

Con: Mostly 12s. I didn't like East LA as much as as the areas around UCLA or Harbor. No tox fellowship.


7) OR -- Oregon Health and Science University
Pro: Love the PNW, though Portland is about as small a city as I'd like to live for residency. Strong tox fellowship. 3 years.

Con: Although their shifts sounded reasonable (8s), multiple residents told us that program culture was such that picking up new patients was the priority over all other aspects of care (i.e., charting), so that they rarely stayed fewer than 2 hours after their shifts (and many times 3+) to wrap up patients. 20-22 8s are ok, but 20-22 11-12s less so. Needs multiple sites because of inherently lower volume at main site (it's a literal Hospital on a Hill).


8) TN -- Vanderbilt University
Pro: Perhaps the first program you think of when someone says "academic EM." Faculty are selected and promoted for their on-shift teaching prowess. Great name, great training, lots of research.

Con: I liked Nashville when I spent some time here, but my partner did not. No tox fellowship (but there is an attached poison control center). Although VU does plenty of charity care and trauma, there's not really a county experience.


9) NC -- Carolinas Medical Center
Pro: Another big EM name. 3 years. Single site but everyone raves about the diversity in patients and the training they get here. Attached tox fellowship. CMC absolutely showers their residents in benefits ($$$). Residents and faculty involved in FOAMed

Con: Charlotte is not really for me or my partner. Odd curriculum - a peds floor month and CLINIC TIME on both Trauma and Ob/Gyn rotations.


10) IL -- McGaw Medical Center of Northwestern University
Pro: Academic, multi-site EM. PD and program culture emphasize producing leaders in emergency medicine.

Con: I'm not sure about Chicago. No real connections with Toxikon.


11) WA -- University of Washington Emergency Medicine Residency Program
Pro: Multi-site program with heavy emphasis on Harborview, which is a truly badass place to train. I love the PNW.

Con: Heavy on the hours, especially intern year. A newer program. I got the impression that it UW is where UCSF was 5 years ago, in that it's got an extremely bright future at a high-caliber medical institution, but there are still some little turf battles and idiosyncrancies to be worked out.


12) NC -- University of North Carolina
Pro: Great academic/community split. Loved the PD and rest of the program leadership.

Con: Time for me to get out of the southeast, I think. 12s aren't ideal. No tox.


13) RI -- Brown University
Pro: I think Brown is the best "small-town" EM program in the game. Academic but also very rigorous training.

Con: No tox. Providence is too small for partner and me.


14) MD -- Johns Hopkins Hospital
Pro: Big name, but less so in EM. Very academic. 4th year comes with a massive shift cut and flexibility to explore nearly any niche.

Con: No tox. Baltimore was not for me. Lots of 12s until 4th year.


15) ME -- Maine Medical Center
Pro: No ortho/ophtho/ENT/plastics means you're doing all those procedures in the ED yourself. Produces docs that are fantastically qualified to do solo coverage in rural areas and can handle anything that walks in.

Cons: Not academic enough for me. No tox. Portland is very, very cold in the winter.


16) NC -- Wake Forest University
Pro: A tertiary care center with a big catchment area, so you see a wide array of both bread-and-butter patients and more esoteric academic ones. Faculty love to teach and residents are universally happy.

Con: Winston-Salem is too small for me, I'd like to move out of the SE. No tox fellowship.


Anything else to add?
I applied to 25 programs and that may even have been too many. Doing my SubIs in three very different places (academic, county, community, and all over the country) was EXTREMELY helpful and I can't recommend it enough. Going into M4 I was sold on the idea of pure county medicine (and was considering Denver, Highland, Hennepin, LAC, etc.) but my aways were crucial in informing my list and where I actually ended up applying.



Withdrew from before hearing anything:
UCSD, BMC

Rejected by:
Emory

Invited to interview, but declined:
Stanford, UChicago, Highland, Yale, NYU-Bellevue, UMich

 

[surely]

Submitted anonymously via Google Form.

Step 1: 230s , Step 2: 240s
EM rotation grades: Honors / Pass / Honors
Inducted into Alpha Omega Alpha: No
Medical school region: Midwest
Anything else that made you more competitive?: Pretty average, but had pubs in several major EM journals including Annals, lots of leadership and community outreach experience. Unconventional pets.

Main Considerations in Creating this ROL:
Fit/”My people” >>> Clinical training/badassness >> Location (Big city north of the Mason-Dixon preferred) > Job placement/ability to get a gig in a competitive market such as PNW (my family is split btwn Seattle area and my home state in the midwest) > Wellness/shift-life balance > Med ed opportunities/mentorship > 3 years preferred but not necessary

1) PA -- Temple University School of Medicine
Pros: 3 yrs. Big city with lots to do yet reasonable cost of living. Close to NYC which I really love but unfortunately didn’t love any of the programs in. Meshed the best with these faculty out of all my interviews. Manish Garg is an amazing resident advocate. Chair and other older faculty have high ranking positions in the hospital system and the med school – make sure the EM department is one of the most robust and go to bat for residents. Residents all seemed very cool, intelligent, active, and easy to get along with! Truly walked the wellness walk with 10 hr shifts PGY1 and 8 hr shifts PGY2-3 on circadian schedule. Lots of trauma with a good proportion penetrating. CHOP for PEM.

Cons: Most residents come from PA or at least the east coast, and therefore tend to stay in that area. Worried their alumni network doesn’t penetrate the PNW markets as well as my numbers 2-4. Only two 2-week elective blocks might make it hard to explore diff niches and prepare a portfolio to apply to fellowship if I decide to go that route, but somehow Dr. Garg managed to convince me this wouldn’t be an issue haha.


2) MA -- Boston Medical Center
Pros: Favorite group of residents on the trail – definitely “my people”. True county hospital where the residents have a lot of autonomy so I know I would be pushed out of my comfort zone and learn a ton. Background in social work so I actually don’t mind the large number psych and substance abuse pts – and for the same reason, the mission of the program and the hospital and their commitment to social justice really jives with me and would make me so proud to train here. I actually like the graduated curriculum with PGY2 procedure year. EM runs every aspect of the trauma, consult trauma surg only if they desire. Boston Children’s for PEM. Lots of elective time and lots of programs and projects going on that I would be interested in spending that time on. It was my first time to Boston and I loved the city: so compact and walkable, lots of young professionals and good dating scene. Lots of grads in the PNW from my brief internet stalking.

Cons: 4 yrs. Expensive COL… worried I would have to have a roommate which I am really over at this point in my life. Also I already live in a very cold snowy state – was hoping to get away from this. Consult ortho very heavily, residents admitted that lack of this procedural experience was a weakness.


3) IN -- Indiana University School of Medicine
Pros: 3 years. Big resident class and all seemed chill yet intelligent. Huge alumni network. Grads going to competitive markets and sought after jobs every year. Love the county/academic split with two sites, but much closer together geographically than the analogous sites at Stanford, Sinai. ICU experience sounds intense but I want to be in a place that will push me out of my comfort zone so I think this fits the bill! Huge faculty with mentorship and research projects in basically every niche imaginable. Indy seems cool, think I could find a nice apt at a good price in a hip neighborhood while starting to pay off my loans! 9 hr shifts with that hour of overlap is ideal to me. All three hospitals/EDs we toured were really nice, not that this really matters, but in contrast to all the inner-city interviews I went on it just stood out. Catchment area is essentially the whole state of Indiana, so wide variety of pathology from inner city gang violence to farming incidents and MVAs. Would definitely take advantage of popular Nepal elective.

Cons: Was hoping to move out of the Midwest. While I could see myself being happy in a swanky crib in Indy, would prefer Boston, Philly, or NYC for the diversity and culture. Huge program with tons of faculty – some of my interviewers mentioned that you really need to be a self-starter/motivate yourself to study and find projects and such on your own because they aren’t just going to hand hold and tell you what to do… I think this is okay because Ive done the “small fish – big pond” thing for both undergrad and med school, but I cant pretend its not daunting compared to the supportive model of Temple, SLR.


4) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: Hands down favorite PD on the trail. Between her and Gisondi and new med-ed fellowship trained faculty coming on, all of my med ed dreams would come true haha. Would obviously come out well positioned for the west coast job market. Cushy shift structure w/36 hrs a week PGY4, protected night before conference. Cool residents, many of them single. Amazing climate and weather (No more seasonal affective disorder!! I say jokingly but actually very seriously…). Best access to outdoor activities of any choices. Tons of awesome elective choices in and out of the department, at Stanford med, Stanford grad programs, and internationally, with 6 full months of elective time – continued salary and stipend during international electives means I could actually afford to spend all of this time abroad! Like the split between academic, county, and community shops so I could discover my ideal practice environment, while most other places I interviewed only had 2/3.

Cons: 4 yrs. COL is ridiculous, even with stipend. Don’t want to live in the suburbs, and SF is too far a commute for me, even though supposedly a couple residents do it. Commute between sites with Cali traffic. Wish there was more time at the county hospital in San Jose – worried Stanford hospital will be very subspecialized and consult heavy, which is the whole reason I didn’t even apply to shops like HAEMR, Penn, Hopkins. 7.5 ICU months seems excessive – most places I interviewed had 4-5.


5) NY -- Mount Sinai School of Medicine - New York
Pros: Rotated here and saw first-hand that the residents worked hard but all loved it and seemed happy. Most diverse patient population imaginable between the two sites. Love the perfect 50/50 county/academic split. The residents were mostly from the east coast but surprisingly down to earth and chill – felt they were “my people”. The PD and Trevor Pour (one of the APDs) were so fun to work with and 2 of my favorite shifts in all of med school! Subsidized housing on the UES, which I vastly prefer to tourist-ridden midtown where SLR has housing. My medical Spanish got exponentially better after just 2 weeks at Elmhurst, so like a lot of their residents I think I would be near-fluent by graduation which I love the idea of. Internal moonlighting as much as you want in 4th yr.

Cons: 4 yrs. I only went to one conference in my month there and it seemed pretty weak. No time for on shift teaching and time isn’t made (NYU is busy too but they let residents step out for morning report 5 days/week). Commute to Elmhurst isn’t ideal, but uber is paid for after hours and subway ride is about 40 mins so I could just bring some reading and survive. COL is not ideal but if I get a subsidized studio it will definitely be doable. 4 years of crowded EDs full of hallway beds and no privacy sounds really exhausting, but the breadth of pathology is probably worth it, right? Right?


6) NY -- Mount Sinai St. Luke's Roosevelt Hospital Center
Pros: Like all the NYC programs I checked out, very diverse patient population. Faculty mostly seemed young & enthusiastic, and very willing to teach on shift. All of the residents really seemed to like each other to the point of being a little cult-y, but hey, as a single person who knows no one in NYC yet, I think this tightness between residents is ideal for me. Seems that lots of grads are going into med ed fellowships or right into academic spots without a fellowship at all, so the mentorship and infrastructure must be there for what I’m most interested in.

Cons: No level 1 trauma center experience besides one month of dedicated trauma in either Miami or Jersey, neither location which interests me at all. Even though the 3 faculty and chief resident who interviewed me were all nice, I didn’t click with a single one and this worried me a bit. I think they sold the whole “family” vibe a little too strong/heavy which says a lot coming from me, a young single person who’s hoping for a close-knit residency class with lots of co-workers to hang out without outside of the hospital… it just seemed very forced, compared to Temple, BMC where I could tell they all liked each other and went out on the town together often, without them having to repeatedly state it outright.


7) NY -- Maimonides Medical Center
Pros: 3 yrs. Hilarious PD I wanted to just sit around and joke with all day. Really fun residents that hang out with each other lots outside of work and like to get a little crazy (im still pretty young and not opposed to the play hard philosophy haha). The amount of money they spent on food and bottles of wine and shots at the pre-interview dinner made me think the department had to be relatively well off. Tons of cool event medicine opportunities including all home Yankee games (Im a big baseball fan) and music festivals all over the country – also you get PAID for all these!! Love Brooklyn. Well established Med Ed fellowship program so great mentorship/infrastructure there. Brookdale and Shock Trauma for the 2 trauma months would be so crazy and fun.

Cons: Even though the residents were cool and fun, I wouldn’t say they were necessarily “my people”. The subsidized housing sounds very affordable but apparently it can be a bit “hit or miss” through the lottery system with some much newer buildings and some older ones. Don’t think that the name will carry me as far in getting a job or fellowship as the other places on my list.


8) VA -- Virginia Commonwealth University:
Pros: 3 yrs. Really liked the city of Richmond. Much better weather than where I live now. Great COL. Really sick patients and plenty of trauma with a good proportion of penetrating. Internal & External moonlighting. Scribes after 1st yr. Residents seemed very nice and down to earth and I really liked every faculty I interviewed with – had some great conversations that day that got me really excited about the program! Ancillary staff and nursing is supposedly excellent (sounds similar to that at UW).

Cons: Similar to concerns with Temple, appears most residents come from the mid-Atlantic or southern US and therefore stay local. Not sure how good PNW job prospects would be. Less academic then most of my interviews, though with only 3 yrs and limited elective time there, Im sure I could find enough interesting activities/research/elective. Most of the residents in long term relationships with or without kids, so I worry I wouldn’t have as many people to socialize with as younger residency programs like SLR/BMC or big programs like Indy/Sinai. Talking with the PD it sounds like there are some growing pains as they are currently trying to expand and make the program less community and more academic than previously.


9) VA -- Carilion Clinic - Virginia Tech Carilion Emergency Medicine Residency
Pros: 3 yrs. Big catchment area with lots of working poor and trauma (mostly blunt) similar to my home institution. Similar to Temple or SLR I like the idea of being the strongest department in the hospital. Lots of females in high up positions, and 100% gender equality in salary really speaks a lot to the department’s priorities. Really enjoyed every single faculty member I met or interviewed with, and loved the enthusiasm they had for potential collaborations and projects if I were to go there. Beautiful place with good weather where I could put a lot of miles on my bike and stay very active. Great COL. Cool electives in Haiti, Nepal, Alaska, and program seems open to creation of more. Appreciate the wilderness medicine curriculum since most places I interviewed don’t have one by virtue of being in a city. No ortho or anesthesia residents at Carillion, making for great procedure competency and a kind of academic/community hybrid model.

Cons: Still a pretty new program, very small alumni network. Most grads just go into the community it seems. Smallest city on my list by far, was hoping to go to a bigger city than where I did undergrad and med school, not one a fifth of the size. As a single person, very worried there is not much of a dating scene. Didn’t meet many residents, not sure if this is a red flag or just related to the smaller program size compared to some others, but I do worry about ranking this highly without knowing if the residents are “my people” or not. The residents I did meet were all married and settled down.


10) NY -- NYU/Bellevue Medical Center
Pros: I love NYC, and its great that housing and both hospitals are all in a few block radius, as opposed to the commute inherent to Sinai and SLR. I am far out of state, so it sounds like I would get top priority for their limited GME subsidized housing. Again, its NYC – diverse pt population, especially with additional Lutheran site being added in Brooklyn. Grads seem to be pulling in great fellowship offers and jobs after residency, and I think the alumni network and reach of the program is broad enough for me to go to any region of the country. I appreciate the commitment to didactics by adding in morning report/conference to combat the lack of on-shift teaching given the large patient census. Internal moonlighting at Brooklyn hospital.

Cons: 4 yrs. The only interview where I got a pretentious vibe from the residents. Didn’t really click with the PD whatsoever, even though he does seem young and cool and ambitious… was definitely a shame. Seems these residents do the most scut work of any of the NYC spots I rotated and interviewed at. When compared to Sinai, maimo, and SLR, not a big focus on wellness despite being in the tough practice environment of NYC. Plenty of elective time but didn’t really hear about any cool opportunities or international experiences during interview day. Between that and the lack of “junior attending” type schedule that BMC and Sinai are offering to PGY4s, I wondered what the point of the 4th yr really was. Pretty much nothing but ED 12s and lots of off-service months the first 2 years.


11) MD -- University of Maryland
Pros: 3 yrs. Tons of on-shift teaching - like literally white board erry day. AMAZING conference and didactics. Shock Trauma will always have something going on – high percentage of penetrating trauma – no doubt these residents are masters of the trauma algorithm by graduation and also just have a ton of really cool stories to tell! I liked the weather (rotated in August and thought it was bearable, while their winters would be a huge improvement for me) and the thought of being able to afford one of these nice apt buildings with roof-top pool for the warm summers. Residents were all really nice to me, and also didn’t seem as over-worked as I expected for doing all 12s. I like that they stack nights.

Cons: Rotated here and just didn’t get the warm fuzzies. The residents were pretty cool actually, but the faculty and leadership was predominately older white men and didn’t seem to be trying to have that much fun on shift. Worried about the volume residents see in the main UM adult ED – lots of long boarding times and no extra hallway beds so often times not a ton of patient movement/volume. Q3 24-hr call while on trauma seems like such a drag, especially when you already have call for all the ICU blocks. 12s in the main ED all 3 years. Lots of sites, some of which are a daunting commute (Peds in DC?!?!) Didn’t get the vibe that the residents hung out much outside of work during my month there. Didn’t love Baltimore – I generally like big cities but I come from a city half the size of Bmore with twice as many good restaurants – it just somehow seemed to have the population without the amenities of other big cities.


12) MI -- Henry Ford Hospital
Pros: 3 yrs. I actually bought into the strictly graduated autonomy model and thought it would work well with my learning style. Scribes after PGY1. Almost every resident goes to Hawaii for a month and it sounds like a great experience! Very affordable COL with tons of cool new lofts and housing options springing up. 10 hr shifts but you only pick up pts for 8 hrs so it sounds like residents aren’t really staying after. I like the EM/IM/CC faculty being part of your training, especially with the month experience in the CDU run by EM/IM.

Cons: Didn’t really connect with any of the residents. Lots of them showed up to the social and the lunch and they were all really nice, but just not “my people” like at BMC or Sinai. Also not my favorite city, but for the opposite reason as Bmore: it seemed deserted, even downtown where all the gentrification is going on – tons of cool new restaurants and apt buildings and sports venues but half of the lots are still empty and I never saw any people out walking around, it was actually kind of eerie like a ghost town. Thought it was strange that the residents weren’t on first name basis with any of their attendings and seemed put-out when I suggested that actually was the case everywhere else I visited.


13) NY -- New York Methodist Hospital
Pros: 3 yrs. Great location in Park Slope. PD has been with the program since its inauguration 20 yrs ago and is really invested, had all sorts of ideas for projects I could get in on were I to go there, similar to VTech… I am a sucker for that kind of wooing and initiative. No ortho residency program so residents do all their own. Ortho and ophtho electives with the respective department chairs sound cushy, educational, and over-all amazing. Great ultrasound curriculum.

Cons: The rest of the faculty besides the PD seemed eccentric and almost strange to me - had really hard time connecting with them. The program has been around for 20 years and still doesnt have a great name for itself which is a little worrisome to me. VTech is much younger and already trying much harder to make a name for itself. None of the PGY3s had jobs lined up yet, in contrast to other places I visited in November like Indy and Stanford where every single one was already set when I interviewed. Worried that the program wouldn’t set me up for the best jobs in the tightest markets. Only one month of elective time and not the most diverse faculty mentorship (most seem to do US – not many fellowship trained in anything else) to discover and develop an academic niche.


Anything else to add?
I know I put a lot of "cons" for each program relative to those above, but the pro-con lists here are copied and pasted straight out of the document I was using to compile all my data and make my final ROL, so I wanted to weigh everything fairly. I actually truly liked and could picture myself training at any of these programs.
To put into perspective how much I grateful I am for this interview season and how much I loved all of the programs above, I would be SO happy to match at any of my top 12, and I will probably have some sort of coronary event if I match in my top 4.

Also forgot to add that I actually have no clue what grades I got on my two away rotations, zero transperancy there. I'm just guessing based on the lack luster comments I hear in interviews about my first SLOE, and the superb comments I heard out of my second one. In reality, either the Pass or the Honors could have been a High Pass with just slightly better or worse comments. Who knows!!

(I did use the rotations for credit, but my school uses letter grading (A, AB, B, BC, C, F) and makes the away rotation directors fill out our grades as such. I assumed the "B" I got was equivalent to a "Pass" and I assumed the "A" I got was equivalent to an "Honors" on that school's scale, but who knows lol.)


Applied to:
Like 50ish (lot of reaches but hey, a girl can dream right?)


Rejected by:
Emory, UCSF (waitlisted), OHSU, Washington Seattle (Waitlisted), USC, Highland, Denver, U of Chicago (waitlisted), Northwestern (waitlisted), Cincinnati, Pitt, Carolinas, BID, Wash U, Regions, UC Davis, Utah, UNC, Lincoln Bronx, New Mexico, Maine, Cooper, UT Austin. Never heard from Vandy, Hennepin, Advocate (step scores probably not high enough LOL), Maricopa, Jacobi, Downstate, UCSD, UTSW, Christiana, or Stony Brook

Invited to interview, but declined:
A couple of Chicago programs that are totally awesome, but I'm trying to branch out! The above, plus my home institution (left off for anonymity, and also because its an AMAZING program that I only ranked lower because I've lived here all my life and am ready to leave).

 

[surely]

Submitted anonymously via Google Form.


Step 1: 210s , Step 2: 230s
EM rotation grades: High Pass / Pass / Pass /
Inducted into Alpha Omega Alpha: No
Medical school region: Southeast
Anything else that made you more competitive?: Multiple leadership positions throughout med school
Publications and poster presentation at a national conference
Good amount of global health experience
EMT and other interesting stuff before med school
Moderately interesting hobbies
I've been told I'm a normal person

Main Considerations in Creating this ROL:
Gut feeling, prefer to live in the south, potentially interested in academics and/or global health, actually kinda interested in newish programs. Perceived pathology.

1) GA -- Emory University School of Medicine
(+): Grady is awesome, would get incredible training and experience. Amazing program with a great reputation. I know EM treats underserved populations everywhere but its most obvious here and its also something I've focused on before and during med school and something I hope to continue to focus on. Loved all the residents and faculty I met. Love ATL. Tons of opportunity to explore interests I have like academics and such. I feel lucky to get this interview TBH.

(-): I don't really have any?


2) FL -- Jackson Memorial Hospital
(+): Felt like a more global version of Emory. Really liked all my interviews and the residents. Lots of opportunity for global health and academics. Ryder Trauma is pretty cool. Clearly great pathology. Had a delicious cuban and some solid goat so thats a plus.

(-): Don't have much in the way of cons. I like ATL a bit more than Miami and thats why this is #2.


3) AL -- University of Alabama
(+): The people were awesome, pathology is probably great, birmingham is cool. I liked the idea of tracks in residency.

(-): No big cons, just didnt like as much as the two above it.


4) SC -- Greenville Health System
(+): Similar to UAB, cool people, great pathology, greenville is really cool. Had a blast in all my interviews. Probably the most enthusiastic faculty (WVU being a close second in this department). I think it would be cool to get in on this program early and help shape it.

(-): Again no big cons, just gut feeling that I liked 1-3 more.


5) GA -- WellStar Kennestone
(+): Really liked the faculty. I think it would be super cool to be the first class especially with not many other residencies in the hospital to compete with. I just think this experience would give me really good training.

(-): I really think being in a new program would be cool, which pushes this up this far, but uncertainty about possible opportunities in global health and academics keep it from moving up.


6) SC -- Medical University of South Carolina
(+): Easily my favorite residents and faculty on the interview trail. Love Charleston, would love being on the coast. Plenty of academic and global health opportunity.

(-): Not sure the pathology is at the same level as 1-5. If they had more community experience they would be higher.


7) KY -- University of Louisville
(+): Well established program. Residents and faculty were great. Loved the PD. Great pathology.

(-): I heard something about interns presenting to upper levels and I'm not sure I'm a fan of that. Not sure I want to live here more than places 1-6.


8) OH -- Ohio State University Medical Center
(+): Surprised I got this one considering they state a step 1 cutoff >220. Residents were pretty awesome, I liked the faculty. Really liked that the PD seemed like he had put time and effort into learning about me through my application. Cool city.

(-): Not sold on the pathology and not sure I like having a dedicated cancer ED. I like academics but they seemed too focused on it for me. Not in the south.


9) NC -- Wake Forest University
(+): I liked everyone here. Very established program with clearly great training. Felt solid all around.

(-): Nothing stood out compared to anything else. Would still be very happy here.


10) WV -- West Virginia University
(+): Seems like a pretty high acuity ED. Residents seemed super competent. Faculty (especially Dr. Shaver) were amazing. Best swag I got on the trail. Lots of fun outdoor stuff to do really close.

(-): Not sure I want to live in Morgantown


11) MS -- University of Mississippi
(+): Residents were awesome. Pathology appears really good. I liked how receptive they are to resident feedback and how much they are willing to continuously change and improve.

(-): Kinda far from my ideal location. Jackson seems like it will be a cool place in 10 years, but not yet. Honestly liked this place more than I thought I would until I interviewed with the PD (cold, abrasive, unwilling to answer questions in any way that seemed like he cared, unwilling to make eye contact). I get that that may be his style, but its a bad style for a PD to have in interviews and the program isn't enough of a big deal to play hard to get. Tour of Jackson (basically just drove through a sea of suburbs) was such a turn off.


12) NC -- East Carolina University/Vidant Medical Center
(+): I thought the PD was hilarious (in a good way). Good pathology. Liked how unopposed the residency is.

(-): Residents seemed meh (I understand that meeting just a few is not always representative of the whole). Don't really want to live in Greenville, NC, but also wouldn't hate it.


13) TX -- TX A&M Scott & White Memorial Hospital
(+): Established program with a good reputation. Good pathology. Really liked all of the faculty I talked to (PD is super cool). Would love a graduation belt buckle. In a different location this would be much much higher up.

(-): Just too small a town and too far away from where I want to be for the positives to overcome location.


Anything else to add?
My school doesn't have a high pass grade so everything was actually recorded as pass, but I know I had 1 each of top 1/3, middle 1/3, bottom 1/3 SLOEs (not in that order). I guess my bottom 1/3 SLOE still said nice things or I don't see how I would have gotten some of these interviews?

My actual rank list is adjusted a bit for personal reasons.

Applied to:
Too many to count (>70). In hindsight, probably overapplied, but I wasn't confident enough in my Step scores. Feel kinda bad that I'm contributing to the overapplying and perceived competitiveness.

Withdrew from before hearing anything:
None

Rejected by:
Vanderbilt, Cincinatti, Carolinas, Doctors Hospital, UPMC, Alleghany (sp?), Chicago, Denver, Utah, Maine, UNC-Chapel Hill (Waitlisted). And silence from about a million more.

Invited to interview, but declined:
UF- Gainesville, Ocala, Kendall Regional, MCG, Crozer-Chester, FAU, LSU-Shreveport, UCF-Orlando, Arkansas, LSU-Baton Rouge, Grand Strand

 

[surely]

Submitted anonymously via Google Form.

Step 1: 250s , Step 2: 270s
EM rotation grades: Honors / Honors /
Inducted into Alpha Omega Alpha: Yes
Medical school region: Northeast
Anything else that made you more competitive?: GHHS, teaching/med ed involvement, some research, top 10% SLOEs.

Main Considerations in Creating this ROL:
Proximity to family, strong resident education, ability to get involved in resident and/or med student education (preferably both). Ultimate goal is academics, preferably without fellowship, so applied to many more 4-year than 3-year programs. Didn't even look at shift length and shifts/month, figure I'll work hard wherever I go and cared a lot more about the above criteria and how much I clicked with the residents & faculty.

1) CT -- Yale New Haven Medical Center
Pros: really just got the "warm fuzzies." Clicked with the residents both at the pre-interview drinks & at the interview, had some really interesting discussions with faculty interviewers and felt they were invested in helping me make my career what I wanted. I've lived nearby and actually really like New Haven - easy to get around, affordable, great food, good arts/culture, enough badness in the area to make for good EM training but plenty of very liveable neighborhoods, plus close to family. Many opportunities to develop my skills as an educator.

Cons: None for me. I guess location for some people, but they don't know what they're missing.


2) RI -- Brown University
Pros: really clicked with faculty, loved PD; as above, felt they were invested in helping me develop my career. Possibly even more already established ways to be involved in med ed (e.g. facilitiating med student small groups). Still reasonably close to home.

Cons: didn't click as much with residents at pre-interview dinner, felt a little bit less friendly. Zink leaving as chair - I'm sure the department will be fine, but would've loved the opportunity to work with him (his book is awesome, highly recommend it as pre-residency reading). Slightly smaller city than I'd prefer, but I've lived in similar sized cities and enjoyed it. I wrote down "heavily graduated responsibility" though I don't remember details, but that's a drawback for me.


3) MA -- Boston Medical Center
Pros: Felt I clicked with faculty and most residents (less so with my resident interviewers, but it was the end of a very long day and I think they were understandably exhausted). Boston's a nice city, pretty close to home. Probably the best mix of county and academic I saw - I loved that I could really develop my skills as an educator while also continuing to serve an underserved population. They really walk the walk when it comes to serving the underserved - my med school serves a county population but has way fewer resources to actually promote long-term change, whereas BU had so many different programs. Super impressed by their substance abuse counseling program, research on health inequities & social determinants of health, etc.

Cons: high COL, not sure I could afford my own place without a long commute. Fairly strict graduated responsibility.


4) PA -- Hospital of University of Pennsylvania
Pros: innovative education curriculum for residents, very open to resident involvement in improving & changing it. Philly is a very liveable city, reasonably close to home. Strong off-service rotations, peds at CHOP.

Cons: some residents said they didn't get enough bread-and-butter EM, not enough ortho procedures, and not enough ophtho experience. The ortho thing is probably true at most of the programs on my list, since they're largely academic centers, but having a PGY4 say that they didn't feel comfortable doing a slit lamp exam because ophtho does everything was shocking to me.


5) MD -- University of Maryland
Pros: incredibly strong resident education, both locally & nationally, with world-class educators looking to train the next generation of educators. Incredible trauma experience at Shock Trauma. Affordable place to live, a little farther from home than I'd like but still driveable. Really clicked with the faculty.

Cons: 3 year (so I'd probably have to do fellowship), separate trauma months (not what I'd prefer, but not a huge deal to me), not a big fan of the "team" setup especially as an intern but I can live.


6) NY -- SUNY Downstate/Kings County Hospital
Pros: good combination of academic and county. Really loved the residents - fun, welcoming people, and they come out trained to work anywhere and do anything. Many opportunities to be involved in med ed, including 'mini-fellowship.' Close to home.

Cons: underfunded, a lot fewer resources than BU, really poor ancillary staff. High COL. Have lived in NYC and don't especially want to go back.


7) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
Pros: strong academics, many opportunities to be involved in med ed. Chairs of both departments very involved in residency program. Pretty close to home.

Cons: high COL. Felt like almost no bread and butter EM (and trying to sell MGH as a county experience was laughable), way too many consultants, not a place that would train you to go anywhere. While realistically I want to be in academics, I don't want to have to rely on other people to take care of my patients. Couldn't care less about the big name if they're not gonna give me the training to back it up.


8) NY -- NYU/Bellevue Medical Center
Pros: good mix of county/academic, some med ed opportunities, liked the people overall, close to home.

Cons: better ancillary than some NYC programs but still pretty bad, very high COL, poor trauma and peds experience. Don't really want to be in NYC.


9) IL -- McGaw Medical Center of Northwestern University
Pros: felt like the chair & PD really sold the program in the morning, had a great vision of EM in general and their program specifically. Strong academics, ability to focus on med ed.

Cons: more than half of my interviewers were very cold and standoffish, felt completely uninterested in what I was saying, just really off-putting - I've had some fairly formal interviews, but this just felt like nothing I could say would interest them. Surgery runs all traumas. Over-emphasized their business/administration strength to the point that I felt that was their primary focus and everything else was secondary; as someone with no interest in healthcare administration, this was a drawback for me. Far from home.


10) DE -- Christiana Care Health Services
Pros: largely unopposed program, no competition for procedures. A little farther from home than I'd like. Some great educators, willingness for residents to be involved in improving their own curriculum.

Cons: Delaware. When asked what they do for fun, all the residents said they go to Philly. I'm obviously fine with living in smaller cities, but it seemed like there was literally nothing to do in Delaware itself, especially as a single person. They get med student rotators but aren't the primary hospital of a med school, so fewer opportunities for higher-level med ed stuff (e.g. curriculum design). 3 year, would need fellowship.


11) MN -- Hennepin County Medical Center
Pros: unopposed program, no competition for procedures, residents come out incredibly well-trained. Really liked the people. Strong county experience with lots of resources (incl. a ridiculous number of ultrasound machines).

Cons: 3 year, would need fellowship. Very far from home. Pretty cold, though having lived in the NE it's not that big a deal to me (-10 is not that much worse than 0). Similar to above, have med student rotators but not their own med school so can't do as much UME stuff as I'd like.


12) IL -- University of Illinois Hospital - Chicago
Pros: Liked the residents & faculty. Some med ed opportunities though it wasn't emphasized much.

Cons: 3 year, far from home. Biggest issue for me was rotation at so many hospitals - I really hate commuting.


13) NY -- New York Presbyterian Hospital
Pros: liked the PD, no-nonsense kind of guy. That was about it.

Cons: constantly commuting an hour between sites. No real reason for the 4th year - think this was the only 4 year program that didn't have tracks/mini-fellowships/whatever. Didn't click with residents at all. Incredibly high COL with "subsidized" housing that's basically market price (i.e. impossible to afford as a single person). Really poor ancillary. Felt like their only selling point was that they're in NYC which isn't a selling point to me at all, especially given the COL & commute.



Invited to interview, but declined:
Denver, Mount Sinai, Cook County, Johns Hopkins, University of Washington, Stanford

 

[surely]

Submitted anonymously via Google Form.

Step 1: 250s , Step 2: 260s
EM rotation grades: Honors / Honors /
Inducted into Alpha Omega Alpha: No
Medical school region: West coast
Anything else that made you more competitive?: Was told by multiple interviewers I had strong SLOEs. Multiple years of EMS work prior to med school, multiple first-author EM-related publications/presentations, all honors during 3rd year

Main Considerations in Creating this ROL:
Location was the biggest factor, needed to be in a certain region due to family considerations. Otherwise fit/people, 3>4. Prefer to have at least some academic ties as considering a fellowship.

1) CA -- University of California Irvine Medical Center
Pros: 3-year. Awesome location, OC is really nice and has some pretty affordable areas that are still really nice. Awesome faculty and leadership, really meshed with the residents. Good amount of trauma and is de facto county hospital for orange county, so you get a mix of county/academic/community patients. Lots of fellowships, strong ultrasound and meded.

Cons: Smaller ED and cramped workspace. Pay for parking. ED is super busy and residents work really hard while on shift.


2) CA -- Kaiser Permanente San Diego Medical Center
Pros: 3-year. Awesome location, SD is the best. PD is great and leadership is really supportive to resident interests and has a strong vision for making the program awesome. Beautiful new hospital with free parking. Big focus on resident wellness, one of the lighter shift schedules I saw on the trail.

Cons: Smaller, newer program. Most of the time working 1-on-1 with an attending with no other residents around so there’s a lack of camaraderie with other residents while on shift. Lower acuity/no trauma at main site, not an academic environment. Sort of a pro and con, but residents don’t really run the department, as there are many attendings on seeing patients at the same time. Very low salary in comparison to others.


3) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Pros: UCLA name/alumni network and the cool opportunities that go with it (international/UCLA athletics/LA events, etc.). Really cool faculty and super friendly/happy residents. Great academic/county/community mix (Antelope Valley is loved by the residents). Lots of elective time.

Cons: 4-year, mostly 12 hour shifts, commute between sites is BRUTAL with lots of traffic. Much more expensive area of LA than Harbor.


4) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pros: High acuity county program, dedicated peds ED with great peds faculty, dedicated psych ED, decent amount of elective time, nice newer ED, nationally renowned program with well-known faculty, friendly residents, mostly 8-hour shifts with 1-hour of dedicated teaching/signout at beginning and end of shifts.

Cons: 4-year, LA is not my favorite area of southern California, but Torrance/Redondo beach isn’t that bad and is relatively affordable. Lack of funding and international electives. Parking is awful.


5) CA -- University of California San Diego
Pros: Awesome location. Really great faculty with lots of well-known names and pumps out tons of research. Basically every fellowship available. Super chill residents.

Cons: 4-year, and not sure of utility of 4th year, it is basically just a repeat of 3rd year, not that much elective time for a 4-year. PGY4s seemed a bit burnt out. Trauma is separate from the ED and you only see it when rotating on the trauma service. Lots of commuting between sites. A bit too academic.


6) TN -- Vanderbilt University
Pros: LOVED this program, but location is a bit of a deal-breaker. 3-year. Awesome focus on wellness/not too heavy of a shift load. Really meshed with residents and faculty, probably had my best interviews here. Amazing opportunities between international electives and sports medicine with the Predators/Vandy athletics. Good amount of fellowships. Great PEM exposure, great mix of county/community/academic patients at the hospital. Low amount of commuting between sites and free parking.

Cons: Location. Nashville is a cool city but far from family and not where we want to settle long-term. If this were in a better location it would be in my top 2 easily.


7) CA -- Alameda Health System - Highland Hospital
Pros: Awesome county experience with few other residencies to steal procedures, super happy residents who were a blast to talk to and are incredible clinically, super cool faculty. Nationally renowned program.

Cons: 4-year. Location. Oakland is expensive and not that nice. Not really a lot of nice and affordable places to live nearby. Another program that would be higher if it was in a better location.


8) CA -- Loma Linda University School of Medicine
Pros: 3-year. Still in socal. Strong PEM and international experiences.

Cons: Inland Empire is “an hour away from everything.” Not my favorite part of socal as it gets super hot, gets the smog from LA, but you have to drive a ways to really do anything. One of the heaviest shift loads I saw on the trail (22/20/20 10s in 1st/2nd/3rd year). No food cards for residents. No caffeine or meat in cafeteria (minor point, but interview lunch was by far the worst food I had at any interview, concerning because I will probably be eating at the cafeteria on a fairly regular basis).


9) SC - Medical University of South Carolina
Pros: 3-year. Actually really enjoyed this interview day, everyone was super chill. Only level 1 trauma center in the state, dedicated peds ED. New fellowships coming soon (sports, tox). Charleston is a really awesome city. Awesome free food options in hospital (Chick-fil-a!).

Cons: Location is far from family, but otherwise nothing really negative really stood out.


10) CA -- University of California Davis
Pros: 3-year, still on West Coast in an affordable area. Massive catchment area and tons of trauma. Residents all seemed happy. Get some community exposure through Kaiser.

Cons: Not a huge fan of Sacramento, not a lot going on unless you drive 2+ hours. Interview day was a bit odd with the interviewers having standardized questionnaires, and had one very awkward interviewer. 6-week orientation block that starts the second week of June.


11) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: Stanford name/alumni network/resources. New hospital opening soon. PD is focused on making Stanford an EM powerhouse. Abundant wilderness medicine and global health opportunities. Nice surrounding area, high salary.

Cons: 4-year. COL in the area is absurd and is still far from home. In midst of curriculum shift, will be a 4-year program with only 3 years of residents. Lots of driving through traffic between sites. Concerned about acuity at both Stanford ED and Kaiser, wish there was more time spent at Valley. Really focused on academics.


12) CA -- University of California San Francisco - San Francisco General Hospital
Pros: Big name, lots of fellowships available, had great interactions with interviewers. 50/50 county/academic mix.

Cons: 4-year. Not a huge fan of SF and COL is ridiculous. EM is a relatively new residency and doesn’t have much clout in a hospital with a lot of elite residencies and as such still has a lot of turf wars with other departments, didn’t really click with residents and at the dinner one of them straight up said they were unhappy with their residency choice, this was the only time I heard anything like this on the interview trail and was very off-putting.


Anything else to add?
In retrospect, I definitely over-applied. If I could do it over again I would probably apply to around 20 programs and do no more than 10 interviews, as by my last couple interviews I was kinda over it. Also, heard a lot about regional bias prior to the application season, but I didn't really feel like I had issues getting interviews outside of the west coast. YMMV though.


Withdrew from before hearing anything:
U of Arizona, ECU, Grand Strand Regional, Florida Atlantic

Rejected by:
Carolinas Medical Center, LAC+USC (waitlisted first)

Invited to interview, but declined:
UCSF Fresno, Kaweah Delta, Kern, UC Riverside, UNLV, Maricopa, U of Arizona South, UT Austin, CHRISTUS Health/Texas A&M Corpus Christi, U Miami/Jackson Memorial, Kendall Regional

 

[surely]

Submitted by @Nousernamedo via Google Form.

Step 1: , Step 2:
COMLEX Level 1: 560s, Level 2: 620s
EM rotation grades: Honors / High Pass / Honors /
Inducted into Alpha Omega Alpha: No
Medical school region: Midwest
Anything else that made you more competitive?: Student government every year. Top 15% of class.

Main Considerations in Creating this ROL:

1) MI -- Michigan State University/Sparrow Hospital - Lansing

2) SC -- Grand Strand Medical Center

3) OH -- University of Toledo Medical Center

4) OH -- Mercy St. Vincent Medical Center

5) FL -- Florida Hospital Medical Center Orlando

6) PA -- Albert Einstein Medical Center

7) OH -- Doctors Hospital-Ohio Health

8) CA -- Desert Regional Medical Center

9) CA -- Kern Medical

 

[surely]

Submitted anonymously via Google Form.

Step 1: 260s , Step 2: 260s
EM rotation grades: Honors / Honors / Honors
Inducted into Alpha Omega Alpha: Yes
Medical school region: Southeast
Anything else that made you more competitive?: AOA, GHHS, top 5% of class, top 10% SLOEs, significant research, significant work experience, interesting hobbies brought up at every interview.

Main Considerations in Creating this ROL: Academic focus. Multi-site exposure. Interested in academics, medical education, leadership/admin, and critical care. Fit. Location (west coast best coast). "Prestige." Career opportunities for fiancee.

1) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: Academic, community, county exposure. Tons of critical care time. Academic and medical education emphasis. Big picture medicine at Stanford. Stanford name and alumni network are a plus. ACCEL lines look like a serious, structured way of utilizing the 4th year longitudinally. PD is a badass. Gisondi from NW as vice-chair of education so excited to see him pull the program up. Loved the faculty and residents. New 4th year is a double-edged sword, but I'm excited to help drive and develop the program, and it also helps decompress the schedule. Meaningful emphasis on wellness with protected time the night before conference, ROAR. Off-service learning from other elite physicians. Career opportunities for fiancee. Location is beautiful.

Cons: There are many. COL. Traffic. Commutes between sites might be a pain. New 4th year. Relatively new departmental status at a storied institution with well-established specialties, so I'm worried about turf battles and the role of EM in the Stanford machine. Department is in search for a chair, so I'm worried about potential leadership issues. Biggest con is probably the strength of clinical training at Stanford and KP. Don't spend much time at the county site. Stanford name in EM isn't huge by any stretch of the imagination.


2) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Pros: Liberal arts education in EM to become a renaissance EP. Academic and county exposure. Beautiful location. Loved faculty and residents. Lots of faculty with med ed background.

Cons: COL. Traffic. Reputation isn't that impressive here compared to other programs in LA. Commute to OV and 12s worry me a little.


3) IL -- McGaw Medical Center of Northwestern University
Pros: Academic focus. Huge emphasis on training leaders. Massive alumni network. Clicked with residents and faculty.

Cons: Not a huge fan of Chicago. Limited time at Gary, but also have to commute pretty far to get there.


4) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pros: Academic-type county program. Great clinical training. Easily best location of all my programs by far, get to live on the beach! Super fun residents and chill faculty. Superb shift structure.

Cons: Single site county hospital with all the woes and limited spectrum of pathology that entails. COL. Traffic.


5) CO -- Denver Health
Pros: LEGENDARY FORGED IN FIRE, etc etc training. Academic, county exposure. Beautiful location. Denver name and alumni network. Emphasis on training leaders in EM.

Cons: Work super hard here, so I'll be paying for the name and training. Doesn't look like there's much time to "explore a niche."


6) OH -- University of Cincinnati College of Medicine
Pros: One of the first EM programs. Alumni network. Leadership emphasis. Flight medicine is an interesting gimmick, but affords killer autonomy and training experience.
Cons: Ohio


7) MA -- Harvard Affiliated Emergency Medicine Residency at Brigham and Women's
Pros: Hahvahd. Emphasis on training great docs and future leaders. Loved how invested the department leadership was during interview day, speaks volumes.
Cons: Concerned MGH and the Brigham might be a little too academic. One of the few places I really questioned getting to see enough "bread and butter." Boston is cold and expensive.


8) CA -- Alameda Health System - Highland Hospital
Pros: Name. Training quality.

Cons: Pure county experience, limited academic opportunities. Heavily inbred program. Not the most exciting part of CA.


9) TN -- Vanderbilt University
Pros: Huge emphasis on resident education.
Cons: Nashville is alright. Not a lot for my fiancee.


10) PA -- University of Pittsburgh Medical Center
Pros: Well-known EM program. Jeep shifts seem pretty neat. Leadership emphasis.

Cons: Seem to work super hard over the 3 years. Pittsburgh surprisingly cooler than I thought, but still not my city.


11) NC -- Carolinas Medical Center
Pros: One of the top programs for some reason. Didn't really feel it or see why during my interview day. Maybe PD and chair just didn't feel the need to sell it to me? CMC name and alumni network. Cheap COL. Minimal traffic.

Cons: Time to leave the south yall. Terrible interview experience left a big sour taste in my mouth.


12) MD -- University of Maryland
Pros: Shock trauma. Major leadership emphasis. Clicked with residents and faculty. Great teaching.

Cons: 12s. Baltimore isn't my city.


13) DC -- Georgetown University Hospital/Washington Hospital Center
Cons: Nothing really stood out as a big negative. DC is expensive, traffic sucks. Just a relatively mediocre program.


14) NC -- University of North Carolina
Pros: Academic and community exposure. Great emphasis on teaching and education. Cheap COL.

Cons: Mostly trains community docs. Commute to Wake Forest isn't fun. 12s during intern year.


15) IN -- Indiana University School of Medicine
Pros: Storied program. Academic and county exposure.

Cons: Indiana. Weird interview and resident interactions.


16) CA -- Los Angeles County/University of Southern California Medical Center
Pros: One of the best. Massive alumni network. Killer name. I love LA.

Cons: COL. Traffic. Work way too hard, mostly 12s. Though, schedule looks to be changing with new PD, which is cool. Felt they were very high and mighty about their social justice mission. Highly unpleasant interview experience: blind interviews that served no purpose (other than to save interviewers time from reading applications), no coordinator keeping time so my last interview was 5 minutes, resident interviewer grilled me on the most bizarre things like why I enjoyed a particular television show.


17) MD -- Johns Hopkins Hospital
Pros: Very interesting 4th year, sort of a mini-fellowship. Academic for sure. Get to learn from the best and brightest.

Cons: PD seems to be a massive micro-manager. Incredibly defensive about a relatively minor match violation. Implicit requests for thank-yous during interview day incredibly off-putting. Didn't enjoy my interviews. Baltimore not my city. UMD seems to be far and away the superior program in the city.


Rejected by:
Emory, BIDMC, UCSF

 

[surely]

Submitted anonymously via Google Form.

Step 1: 220s , Step 2: 250s
EM rotation grades: Honors / High Pass
Inducted into Alpha Omega Alpha: No
Medical school region: Southeast
Anything else that made you more competitive?: Not really. Late EM convert. From the deep south, which might help applying in the deep south?

Main Considerations in Creating this ROL: Fit = location = training > prestige. Peds experience is important to me.

1) FL -- University of Florida - Gainesville
Pros: Best fit with residents and faculty, shock trauma, incredible peds ED, warm weather, just over an hour drive to the beach, SEC football.
Cons: None?


2) VA -- Eastern Virginia Medical School
Pros: Fit, liked Norfolk, Virginia beach nearby
Cons: Internal PA moonlighting only

SO wanted EVMS to be #1, so ranked higher than I might have done otherwise.


3) AR -- University of Arkansas
Pros: Fit, liked little rock, only hospital, strong female faculty, moonlighting
Cons: Far from family


4) LA -- Louisiana State University - Baton Rouge
Pros: SEC West football, I-10, close to family


5) NC -- University of North Carolina
Pros: Decent fit, wonderful people, mix of community and academic, good reputation, nice area to live. Dr Binz is pretty cool.
Cons: Don't want to commute between 2 sites 45 minutes apart, more curtains than doors in the ED. Cost of living in Chapel Hill is relatively high compared to the rest of the south.


6) SC -- Palmetto Health Richland
Pros: People seem nice, like Dr. Hassinger in particular. Strong U/S training, Hawaii rotation, lots of resources
Cons: Major boys club, not many residents at dinner


7) MS -- University of Mississippi
Pros: all training at one site, really liked the residents, low COL, great moonlighting opportunities
Cons: Jackson


8) NC -- East Carolina University/Vidant Medical Center
Pros: Close to SO's family, not too far from the beach, low COL,
Cons: Greenville isn't my cup of tea, but could be livable. Not the best fit


9) VA -- Carilion Clinic - Virginia Tech Carilion Emergency Medicine Residency
Pros: Roanoke is very pretty and close to SO's family. COL is good. Moonlighting available. Enjoyed my interview.
Cons: Residents seemed overworked


10) TX -- TX A&M Scott & White Memorial Hospital
Pros: Really liked PD, ED was nice, impressed by peds experience, COL is very low
Cons: TEMPLE. SO would have trouble getting a job, residents all seemed to be buying houses and having babies, which is totally not where I'm at. If this place was anywhere but Temple, it would be ranked much higher.


11) OK -- University of Oklahoma College of Medicine/Tulsa
Pros: Enjoyed the residents, could see myself liking Tulsa
Cons: Level III trauma center with two Level IIs in the same city and a level I 45 minutes away. Clearly residents get their numbers, or they wouldn't be accredited, but Level III is not for me.


12) GA -- Wellstar Kennestone
Pros: Very high volume with minimal competition for procedures etc. Faculty seem motivated to build a great program. HUGE new ED under construction. Concierge service.
Cons: New program with no residents yet. If this program were even 5 years old, it would be much higher on my list.

 

[surely]

Submitted anonymously via Google Form.

Step 1: 220s , Step 2: 230s
EM rotation grades: High Pass / Honors /
Inducted into Alpha Omega Alpha: No
Medical school region: Southeast
Anything else that made you more competitive?: Nope

Main Considerations in Creating this ROL:
1. Location
2. Personality fit with program leadership and residents
3. Three year program
4. Large academic center

1) FL -- University of South Florida
Can't beat Tampa, FL. It is a rapidly developing city with a ton to do, great weather year round, beaches close by. New program director has a new vision for the program and has started making changes (like no more 12s and lessening the total hr/month from 230s to 190s). Residents seem happy with the program and were normal, nice people. ED was nicely laid out. Tampa General was the largest hospital I visited at >1,000 beds. Hospital employs both academic faculty and private groups throughout the hospital, meaning residents get the normal academic feel with some exposure to community medicine when admitting/consulting the private practitioners.


2) FL -- University of Florida - Gainesville
I love this town, though I can see how many people would see Gainesville, FL as a glaring negative if they were not from around there. College sports, bar scene and outdoor activities are the main things to do in the area. Program director is one of my favorites. The residents are a huge positive for this program, very relaxed and easy to have conversations with. Shands is a very large academic center with a huge catchment area. The ED is nice, set up with 3 pods and a fish bowl team room in each pod. Work 10s mostly but 12 hr shifts on weekends to get more weekends off.


3) VA -- Virginia Commonwealth University
Richmond, VA is a sneaky cool city. Very hipster-like vibe, lots of unique restaurants and bars, very historic city. By far the longest interview day, but I liked every single interviewer. Extremely nice program director, very dedicated to inclusiveness. Residents gave off very relaxed vibe. One of the nicer facilities. Trauma bay/resuscitation rooms are unlike anything I've seen, one giant room with a really cool set up. Ultrasound is heavily stressed in the curriculum and there are a ton of fellowship trained attendings.


4) SC -- Medical University of South Carolina
Obviously no one ever has a bad thing to say about Charleston, SC. The program leadership was energetic. Extremely laid back atmosphere. Residents were some of the coolest I met. Pretty average, but sim lab was pretty nice. Interview day was perfectly concise and to the point. Small program (6 per class) but looking to expand either this year or next.


5) TX -- TX A&M Scott & White Memorial Hospital
This would be top 2 if not for location. Temple, TX is right in the middle of nowhere and is exactly what you imagine it to be. One of the coolest program directors there is. Residents are really tight-knit with a couple classes even owning boats together. This was the nicest ED I visited, newly renovated. Have to do 1 month of medicine at the VA.


6) PA -- Drexel University - Philadelphia
Philly is awesome minus the cold. Big city but very walkable city. Cost of living higher than anywhere else I interviewed. New program leadership that I really enjoyed talking to. Recently off probation and upfront about the fact that the old leadership was stubborn, refused to change, and there was a decline in resident satisfaction. They now have great ideas for the direction of the program with a resident-first attitude that got me excited. Residents go out together and hang out outside the ED with ED nursing staff a lot. Facilities were kinda old looking. Unique ICU rotations, all staffed by ED critical care physicians, and a TON of it. A lot of community exposure as well.


7) WV -- West Virginia University
Another one of those programs that would probably be ranked top 4 if it wasn't in Morgantown, WV. WVU campus is nice and there's a ton to do outside. They claim it rarely snows more than twice per winter and usually no more than 2-3 inches per storm. Nearest large airport is Pittsburgh though. Really young leadership group that seems willing to listen to residents. A lot of recent changes to curriculum based on resident feedback. Residents were cool for the most part. Basically the entire hospital was being renovated but the lobby is done and it looks like a 5-star hotel lobby. ED also under construction. Excellent community exposure and also a month of extremely rural medicine.


8) NC -- East Carolina University/Vidant Medical Center
Not wild about Greenville, NC. Basically a 2 hour drive from any major cities. Not the place for a single resident looking for night life. At least the cost of living would be crazy low. The program leadership was pretty quirky, very involved with the residents, and extremely nice. Program director seemed really invested in board preparation. I really liked the residents I met at dinner. Essentially an unopposed residency, with no ortho or anesthesia residencies at the hospital to compete with for procedures. A lot of directly consulting attendings from the ED since there aren't many other residencies in the hospital. Not a single mention of research, which I guess is a negative if you're into that...


9) LA -- Louisiana State University - Baton Rouge
Baton Rouge, LA is a bigger city than I thought. Also way closer to New Orleans that I thought. College town with a really cool campus. SEC football dominates the culture. Seems like most residents live 2 minutes from the hospital. Program director is young and has a lot of swag. The leadership presents themselves very well. I had to miss the dinner so I only met the two residents that did the tour, who were cool and normal people. The hospital is private and catholic, so there are crosses everywhere and the hospital is really nice. The SDN review for this program is a wild read… I would just ignore it. My understanding is that the program has undergone a ton of changes in the past 5 years- the hospital they were originally at closed, so they moved to Our Lady of the Lake (they claim this is for the better anyways). They seem to still be working out the kinks as they encounter them, but I get the feeling there aren't many more kinks to work out.


10) FL -- Florida Hospital Medical Center Orlando
People either love or hate Orlando, FL. Traffic is horrible and it's a bit touristy, but there's always something to do and the weather is great. The program director was very nice, but I don't think I would mesh well with some of the other leadership. At the dinner, some of my conversations led me to believe the residents aren't where they need to be education-wise. Private hospital with extremely nice facilities. They've lost 2 of their residents from the class of 2018 (idk why but draw whatever conclusion you want). Many students who rotate here have very negative reviews, citing lack of communication/organization within the program and lack of teaching from attendings. With ORMC just across town, you may not get to see certain patholgy that only the large academic centers will see. It is not a trauma center so you do your trauma months at another site that is a busy level 2 trauma center. Would be ranked last if it wasn't so close to home.


11) KY -- University of Louisville
Louisville, KY is a really cool place to visit but I wasn't blown away by the neighborhoods residents live in. I didn't mesh well with the residents and didn't get the vibe I wanted from the program director. Older facilities. They are VERY big on autonomy which they present as a positive but I took as a negative. Residents seemed very confident in their abilities.


12) MS -- University of Mississippi
Jackson, MS is meh. Downtown is a mess, but there are towns just outside the city that are more livable. I just didn’t gel well with the program leadership and I thought the residents were a bit peculiar. Research seems very important to the ED Chair and they have a lot of ED faculty in hospital/medical school leadership positions.


Applied to:
59 programs throughout mid-atlantic, southeast and Texas

Invited to interview, but declined:
Kendall Regional, Ocala Regional, North Florida Regional

 

[surely]

EM/IM Combined List
(Emergency Medicine/Internal Medicine, EMIM)

Submitted anonymously via Google Form.

Step 1: 250s , Step 2: 270s
EM rotation grades: Honors / Honors
Inducted into Alpha Omega Alpha: Yes
Medical school region: Northeast
Anything else that made you more competitive?: **THIS IS FOR EM/IM** (@surely if you can put that at the top, that'd be great) (No problem, good luck!)
This is prob a risk to my anonymity but I would've really appreciated some info on these programs when I was applying, so I figured I'd pay it forward.

Main Considerations in Creating this ROL:
Location, ability to go into academics with a focus on med student education, fit with residents/faculty

1) MD -- University of Maryland
Pros: strong program in both EM & IM, great patient diversity, you get to see everything, strong focus on education from leaders in the field, amazing critical care experience, really clicked with the people, option of 6th year critical care

Cons: treated as intern on EM side during PGY2, plus they have a weird team-based setup in the ED that I don't love (I know they're not the only EM/IM program that does the "resitern" thing, and I may have forgotten to list it for some of the others)


2) NY -- SUNY Downstate/Kings County Hospital
Pros: incredible EM program, residents were a really fun group and seem prepared to go anywhere and do anything, met many recent grads as faculty at other programs, lots of opportunities to be involved in med student education both inside & outside of the ED, no "resitern" thing though do EM schedule of a junior resident for an extra year (I think - meaning 12s and not 8s til PGY4, whereas categorical EM residents change to 8s in PGY3), biggest program (so you're not stuck with just one co-resident for 5 years if you don't like them), new 6th year crit care option

Cons: much weaker IM program, poor nursing support, high COL, less patient diversity than Maryland (although an equally underserved population, if not moreso)


3) MN -- Hennepin County Medical Center
Pros: another incredible EM program with amazing training, EM runs the show, EM/IM residents advance with their peers (e.g. PGY2s supervise IM teams, PGY3+ are "pit boss") which may be the only program that does that for both departments, really loved the residents and PD, impressed by the clinic one of the residents started to care for transgender patients (not just for the awesomeness of the clinic itself, which is really cool, but because it demonstrates the incredible level of support the residents receive to make their dreams happen), 6th year crit care option

Cons: far from home - that's literally the only one, otherwise this would've been my #2

Went back and forth between this & UIC for 3 & 4. They were really close for me and I'd be thrilled to be at either.


4) IL -- University of Illinois Hospital - Chicago
Pros: really liked the residents, evenly balanced program in terms of EM & IM strength (probably the only one other than Maryland that's actually balanced, based on my very limited knowledge), Chicago is a cool place, bigger program (3/year as opposed to 2), good opportunities to be involved in med student education

Cons: 4 sites on EM side so you're always commuting, "resitern" on IM side but not EM side (they may be the only ones who do it that way), far from home (the only big drawback for me)


5) DE -- Christiana Care Health Services
Pros: very strong EM program, they have a lot of combined residencies which was kind of cool, flexible residency curriculum

Cons: nothing to do in Delaware, only met male EM/IM residents during my interview day (had to check the website to make sure there were at least some women in the program, but I think it's still less than other programs), not attached to a med school


6) VA -- Virginia Commonwealth University
Pros: EM/IM PD seems fantastic, residents were nice and spoke highly of the EM program, affordable city

Cons: far from home, Richmond isn't really my city, seemed to overemphasize obs which is to me the least interesting part of EM and/or IM, odd IM schedule where you switch every 2 weeks which I would find unsettling, multiple residents said that there's basically no flexibility on the IM side for important events. Had really off-putting interviews on the EM side that felt hostile.


7) NY -- Hofstra Northwell SOM at North Shore / LIJ
Pros: 6th year crit care option, high salary, supposedly good ancillary for NYC...

Cons: Long Island, IM PD spent morning talking badly about other programs. The huge thing was that I met 3 residents, none of whom were happy there. They gave some reasons, including location & weak didactics, but they just seemed disproportionately miserable for unknown reasons, which was enough to put it at the bottom of my list.


Anything else to add?
I applied to all 11 EM/IM programs but ended up declining some interviews (that I would've otherwise loved to go on) due to unforeseen family circumstances. My actual rank list has some EM programs sprinkled in between EM/IM programs based on location and how much I loved them.

For future applicants - many, but not all, of the EM/IM programs incorporate your categorical EM interview as part of your EM/IM interview day. The ones that definitely do are: Ohio State, SUNY Downstate, Hofstra Northwell, and Christiana. UIC & VCU may combine the interview days if asked (though VCU seemed to not like that I asked).
The ones that definitely DON'T (i.e. require separate interview days for EM and EM/IM) are Hennepin & LSU.
I'm not 100% sure for ECU, Henry Ford, or Maryland, though I think they all do a combined interview


Invited to interview, but declined:
Ohio State, East Carolina University, Henry Ford/Wayne State, LSU


(Note from @surely - Appreciate this contribution a lot, especially at the potential expense of anonymity. Not much EM/IM information out there, and the information about combined interviews is particularly kind of you to share!)

 

[surely]

Submitted anonymously via Google Form.

Step 1: 240s , Step 2: 250s
EM rotation grades: High Pass / Honors / Honors
Inducted into Alpha Omega Alpha: No
Medical school region: Midwest
Anything else that made you more competitive?:

Main Considerations in Creating this ROL:
Geography limited my application. Forced to apply IM as backup due to limitation. I'll probably be alright.

1) IL -- Presence Resurrection Medical Center
Pros: Laid-back faculty, laid back interview, fun residents. Trauma at Cook and Mount Sinai. Best community program in midwest.

Cons: Lots of traveling


2) IL -- Rush University Medical Center
Pros: Good exposure to pathology. Residents seemed happy with no regrets. I feel like it's going to be great soon. Like that it's mostly at one hospital.

Cons: New program. Some residents were unimpressive


3) IL -- University of Illinois Hospital - Chicago
Pros: Exposure to different EDs, different systems. Lots of different pathology. PD is super cool.

Cons: Lots of travelling. Being at four different hospitals is cool, but you don't get to form that bond with residents.


4) WI -- Medical College of Wisconsin
Pros: Rotated here. Residents are super cool. Trauma is a strength. Tons of residents at the dinner, which I liked seeing.

Cons: Crime, Milwaukee has a lot more crime than what people think.


5) IL -- University of Illinois College of Medicine/St. Francis Medical Center at Peoria
Pros: Rotated here. The ED Is so quite if you cough everyone can hear you. The design of it is amazing. Probably the best designed ED I've been in. The best meal plan and insurance in the nation. 24/7 access to cafeteria, can pick up anything you want and it's free (starbucks coffee, ice cream, pizza, chips, sandwiches). Some very cool attending. The attendings I worked with are chill but tough tough graders. APD is hot. I had this program above Wisconsin but I just didn't like the odd scheduling here. 2 weekends off per month. Simulation is probably second best in Midwest.

Cons: Trauma is completely separate (like Cook County). The trauma team is in complete control and there are like 3-4 residents there at a time on top of the EM resident. Multiple days when the hospitalists refused admission.


6) IL -- Southern Illinois University
Pros: Speed dating interview day. Loved it and probably one of my better interview days. Faculty super chill. PD/APD make a great team. The best simulation center in midwest, maybe even in the nation (building dedicated to simulation). Resident lounge is sweet. County/community/rural experience.

Cons: Scheduling a little weird. They have shifts from 4:00 pm to 2:00 am on top of the regular night shifts (I could be wrong).


7) IL -- John H. Stroger, Jr. Hospital of Cook County
Pros: Rotated here. It's Cook freakin County. Legendary program. See the sickest of the sick.

Cons: 4 years, extra year played a huge role. Very rude patients, but I can understand why.


8) IA -- University of Iowa Hospital & Clinics
Pros: Very happy residents. Iowa City has a college town feel to it. Get patients from all over the state. Residents were very open to questions. Dinner experience was awesome. The APD is the coolest I met so far. Go Hawkeyes

Cons: Far from bigger cities. Go hawkeyes!


9) MI -- Western Michigan University Homer Stryker MD School of Medicine
Pros: 20 residents means lot of friends.

Cons: The interview day sucked, worst interview day. The PD was odd. I just wanted to leave by the end of the day.

 

[surely]

Submitted anonymously via Google Form.

Step 1: 250s , Step 2: 240s
EM rotation grades: Honors / Honors / Honors
Inducted into Alpha Omega Alpha: No
Medical school region: Southeast
Anything else that made you more competitive?: EMS experience before med school

Main Considerations in Creating this ROL: Perceived quality of training, perceived quality of residents’ lives, interview day feelz

1) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pros: Super strong reputation seemed deserved, great pathology, residents seemed happy, and living in that part of LA seemed pretty awesome even with the traffic/COL

Cons: feel a little uncomfortable about not interviewing with PD at all but it wasn’t a dealbreaker


2) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Pros: really got along with the residents/faculty, liked the diversity of the places they rotate at, new opportunities for EM CC fellowship

Cons: traffic, COL seemed worse in northern LA. Less time at county


3) MN -- Hennepin County Medical Center
Rotated here and love almost everything about this program. They have some really amazing faculty, their stab conferences are fantastic (and they include their EMS personnel), residents super chill and love teaching. Abundant research opportunities. Basically the best-funded county hospital I’ve ever seen. I really think this is the place on my list with the best training

Cons: ...not to be cliche, but the cold. I’m coming from 4 years of southern “winters.” I felt like I’d be kicking myself if I were sitting in my car in minus 10 weather thinking “I could be in Cali right now”


4) CT -- Yale New Haven Medical Center
Pros. Liked this place way more than I was expecting to. The faculty I interviewed with had some really interesting research interests. Cool combination of tertiary care experience and county type population. Residents super chill.

Cons: not real county—lots of consulting, meh on new haven


5) TN -- Vanderbilt University
Pros: another place I liked way more than expected. Really bought into their whole 3+1 year philosophy. Liked the residents and faculty a lot. Amazingly busy flight medicine hub.

Cons: really not into country music. Honestly can’t put my finger on why it wasn’t higher other than the feels


6) IL -- John H. Stroger, Jr. Hospital of Cook County
Pros: close to home/family, super advanced pathology/county population, burn ICU rotation, liked the residents and most of the faculty a lot

Cons: the system is so resource-poor, and I was a little concerned the extra 4th year was more to benefit the hospital than the residents. Nursing is way understaffed. Not sure how I felt about separate, standalone trauma rotation completely separate from ED time


7) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: came away from interview day really loving it. Program director gave a great pitch about the added 4th year. So many cool opportunities to do tech related projects through Stanford. Funding abundant. Beautiful area

Cons: insane COL. Rotation sites pretty far apart and I was worried it would be more of a homogeneous, well-to-do suburban population


8) CO -- Denver Health
Pros: seemed like you become a beast of a resident when it comes to clinical skills. Great reputation. Beautiful area.

Cons: seemed like they really worked the residents hard, which I’m ok with, but also seemed like there wasn’t much time left over for electives or research interests. Just didn’t come away from interviewing feeling as excited as I had hoped


9) IL -- Advocate Christ Medical Center
Pros: lots of trauma/county experience, residents fantastic at karaoke

Cons: seemed like it was a program geared towards producing community physicians as opposed to academic ones. Didn’t love the idea of wearing a jacket that says “CHRIST” with a cross. I know that sounds petty but it is what it is


10) RI -- Brown University
Seemed like a good program but not for me. Direct quote from tour guide [on resident martial status demographics]: “yea this is kind of a young couples program”


11) IN -- Indiana University School of Medicine
Loved this program way more than I thought I would. Dealbreaker was Indianapolis....and one resident saying she wouldn’t ever get a cat because she didn’t want to be lame.


12) CA -- University of California San Francisco/ Fresno
They warned me about Fresno. I wanted to form my own opinion. It’s a great program, but I really hated Fresno


13) MI -- University of Michigan
Really not an Ann Arbor fan. Didn’t feel like it was a great personality fit



Anything else to add?
Sorry for incomplete sentences. Typing on phone

 

[surely]

Submitted anonymously via Google Form.

Step 1: 270s , Step 2: 280s
EM rotation grades: 3 rotations that were Pass/Fail only
Inducted into Alpha Omega Alpha: Yes
Medical school region:
Anything else that made you more competitive?: CK was low 280's, class rank #1, 4 years as an ED scribe, med school tutoring, clinic volunteer, strong SLOEs from middle-low tier programs. Interview season was a roller coaster and having spoken to other applicants and based on my interview offers/post-interview communication I can tell you that I was definitely not a "top" candidate despite the stats.

Main Considerations in Creating this ROL:
Perceived strength of clinical training and CCM opportunities. Applied to a few EM/IM/CCM programs because I'm 100% sure on doing fellowship and also because I love talking about Magnesium levels. With few exceptions, I focused on programs that had high volume (>100k/year).

Did not care about:
-3 vs 4 (although my list favors 4 year programs)
-county vs academic (although my list favors academic)

1) MD -- University of Maryland
EM/IM/CCM (6 years)
Top notch EM, very strong IM, and arguably one of the top CCM fellowships available to EM grads. Die-hard fan of The Wire, but felt that Baltimore was a decent town overall. EM training seems very strong with an inner city population conducive to EM pathology, great airway experience (trauma airway month, Levitan's difficult airway course), quarterly 1-on-1 cadaver lab. Not a huge fan of 12's, but I think that I could make it work. No free meals. No moonlighting in EM. 60-70k visits/year iirc


2) MI -- University of Michigan
One of the most well designed programs in my opinion. Loved the idea of EC3 (ED-ICU), huge focus on EM-CCM with in-house fellowship. Highest volume of ED ECMO (even doing field cannulations on flight evac). 2 shift reduction per month in order to focus on a specialty track (business, US, CCM, global health). Great benefits due to union status with free food, more $$, good healthcare coverage. >100k visits/year. Main concern was having overly differentiated patients at the University site and being at the behest of every consultant known to man.


3) MO -- Washington University St. Louis/Barnes-Jewish Hospital
I think that this place will be a top program in a few years. >100k visit/year with de facto county status. One of the few places where the resus bays were actually filled with patients. Very well designed curriculum with an energetic PD who gives off a great vision for the program. Top EM-CCM fellowship program. This was one of two places (the other being Brown) where I felt that tug in my gut that I wanted to come here.


4) RI -- Brown University
As above, one of the places that gave me that great gut feeling. Similar to WashU in the >100k visits/year with a county population. Resus bays were literally over-flowing during the tour. I liked Providence a lot, although I've heard how it's a mixed bag for a lot of people. Ultimately I felt that programs #1-3 would help my career goals more, although I would be very happy indeed to "fall" down my list to #4.


5) IL -- University of Chicago Medicine
I love the city of Chicago. The program itself is very well pedigreed and turns out top notch clinicians (the most impressive Chicago-area ED docs that I met were UC-trained). The new trauma center in the south side is a huge plus in my book. The leadership is great and the PD deserves a special shout-out for being so likeable and all-around awesome. This is one of the "throw you into the deep end" programs with early ICU rotations and the expectation of managing sick ED patients as an intern.


6) CO -- Denver Health
Not to beat a dead horse, but I very much agree with the common sentiment that everyone is super nice but a wee bit too intense. Residents were joking about how one of them (an intern) didn't get any days off during the holiday season. I'm not sure why this place is so crazy busy given that they have a huge staff and see <70k/year, but the workload is real. Residents seemed insanely competent however, so I guess it works. Had a really great chat with the current EMRA president after he finished managing a crashing hypothermic patient. In short: I could see myself there, but I think that the pace and culture would ultimately not help me reach my specific goals.


7) MN -- Hennepin County Medical Center
Probably the best clinical and procedural training in the country. ED residents seem to do everything from TEEs to left-sided thoracotomies to myringotomies. So many cool things happening here including E-CPR, hyperbarics, advanced cardiac resuscitation research. Nerded out big-time when I met Steve Smith of ECGblog fame. Ultimately, the EM training seemed phenomenal, although I had real concerns about fellowship opportunities coming from a county program in Minnesota that nobody in Internal Medicine will have ever heard of. The vast majority of their grads also seem to stay in the mid-West and Minnesota in particular, which is not where I want to end up long-term. Still, would really enjoy spending 3 years here.


8) MD -- Johns Hopkins Hospital
Great program, got a lot of undeserved flack on the spreadsheet chat imo. Everyone that I met was very personable and I ended up talking with the chairman for 5 minutes about Costa Rican coffee beans. Ultimately, I think that you're trading some degree of clinical expertise for a fancy name, however. The ED felt so, so quiet during the tour. 4th year FAST seems a little oversold given how every 4 year program is basically doing the same thing.


9) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Seemed like a strong program, although I felt like the residents were probably too cool for me. Sunglasses in the mail with the postcard was a real nice touch. At the end of the day though the cost of living in west LA and dealing with LA traffic for 4 years basically trumped everything else though.


10) FL -- Orlando Regional Medical Center
Really liked this place, although I think that it would be an up-hill battle getting an academic job or fellowship coming from here. People were great, cush benefits, and all-around good feels. If I had different goals this could've easily been #1.


11) CA -- Los Angeles County - Harbor-UCLA Medical Center
Liked the ED rounds at the beginning/end of shifts. Great classic county environment with all the classic benefits and classic drawbacks. Again, felt that career goals would be constrained coming from here.


12) MA -- University of Massachusetts
Had everything on paper that would've made it a top program for me, but damn Worcester is a dreary town.


Rejected by:
The ones that hurt: Vanderbilt, HAEMR, Northwestern, Yale, Indiana, Carolinas, Emory, Cincinnati, UNC, UCSF, BIDMC


(Note from @surely - When I made the ROL form, I was like "Should I include a 280s option for the Step score? Nah, surely no one could possibly score that high..." Welp, special shout-out to this person for proving me wrong.)

 

[surely]

Submitted anonymously via Google Form.

Step 1: 230s , Step 2: 240s
EM rotation grades: Honors / Honors / High Pass
Inducted into Alpha Omega Alpha: No
Medical school region: East coast
Anything else that made you more competitive?:

Main Considerations in Creating this ROL:

1) CA -- Los Angeles County - Harbor-UCLA Medical Center

2) CA -- Kaweah Delta Health Care District

3) CA -- Arrowhead Regional Medical Center

4) NV -- University of Nevada Las Vegas

5) MI -- St John Hospital & Medical Center

6) MI -- Western Michigan University Homer Stryker MD School of Medicine

7) PA -- Penn State Health Milton S Hershey

8) MI -- Michigan State University/Sparrow Hospital - Lansing

9) NV -- Sunrise Health

10) MI -- Henry Ford Wyandotte Hospital

 

[surely]

Submitted anonymously via Google Form.

Step 1: 230s , Step 2: 260s
EM rotation grades: High Pass / High Pass / High Pass
Inducted into Alpha Omega Alpha: No
Medical school region: Southeast
Anything else that made you more competitive?: Unusual background, lots of research.

Main Considerations in Creating this ROL:
Near SO, feel for the people there and the morale of residents.

1) NC -- Duke University Medical Center
Rotated. Liked the attendings and residents. Saw a fair amount of trauma and lots of sick patients.

2) NC -- Wake Forest University


3) VA -- University of Virginia Health System

4) VA -- Virginia Commonwealth University EM/IM

5) VA -- Virginia Commonwealth University EM Only

6) SC -- Greenville Health Systems

7) SC -- Palmetto Health Richland

8) VA -- Carilion Clinic - Virginia Tech Carilion Emergency Medicine Residency

9) NC -- East Carolina University/Vidant Medical Center

10) MD -- University of Maryland

11) TN -- University of Tennessee - Nashville

12) NY -- New York Presbyterian Hospital

13) GA -- WellStar Kennestone

14) NY -- State University of New York - Stony Brook
Loved it, bad transportation situation.

 

[surely]

Submitted anonymously via Google Form.

Step 1: 250s , Step 2: 260s
EM rotation grades: Honors / High Pass / High Pass
Inducted into Alpha Omega Alpha: Yes
Medical school region: Midwest
Anything else that made you more competitive?: Good clinicals and some unique hobbies! Otherwise I think just my scores

Main Considerations in Creating this ROL: Feel of program >>> anything else. I feel I'm a competitive applicant and only sent out a handful of applications to places I was sure I'd want to go or be happy. Ultimately ended up going on 11 interviews. Did not want to live in New York/Chicago or West Coast just based personal preference.

1) TN -- Vanderbilt University
Amazing interview day. Loved the PD, The location and the staff I met with. Great resources and really paid attention to the sincerity and passion each of the interviewers had for the program. Best residents dinner and felt like being among family/friends in casual conversation

No outstanding Cons, I felt it would be a dream come true


2) AL -- University of Alabama
I scheduled this interview with the intentions of just exploring more from my comfort zone, but I loved this place more than I anticipated. Dr. Edwards really made me feel like family and each of the interviewers didn't need to keep looking at my applications to have conversation and that spoke volumes. Honestly kept flipping this with my #1 and would be ecstatic at either place. Also a dream come true

Cons: Maybe a little less to do in the area compared to Nashville, but I'm a home-body anyways. Loved the southern hospitality.


3) MI -- University of Michigan
I felt as though this place with its resources, and combination of three sites really has the full experience I was looking for in a residency. I feel if it was 3 years, it would be my #1 just on the intangible of how it is closer to family, but I really wanted to base my program off of feel and training. I think the extra elective time and resources really would make me a bit more comfortable before being on my own, but other programs afforded me the same comfort level.

Cons: None really, maybe the extra year, but I saw the advantages specifically here when applying


4) MN -- Mayo Clinic School of Graduate Medical Education
I really enjoyed the facilities and resources, nearly unparalleled. The commute to work with a comfortable home is affordable and 10 minutes tops, and the interview day was seamless and fun to explore what Rochester had to offer.

Cons: Location is a little less than ideal and was a bit too simulation (albeit, cool simulation) heavy for me. Wanted a bit more of an urban population touch


5) NC -- Wake Forest University
I liked the level of variety they had for Winston Salem, and the cost of living with proximity to work for me was important. The atmosphere of the residents and program was great. Residents were friendly and had the luxury of bragging and making the most of 8 hours shifts.

Cons: I had one bad interview experience where there was no connection or emotion, but I feel I let that get in my way.


6) GA -- Medical College of Georgia:

Pros: Like the residents and unique with the army affiliation. Residents are proud and have big simulation center with every setup you could imagine (basically and ICU of SIM). All the staff and resident interviews were fluid and really made me feel comfortable and welcome.

Cons: The area, while it has the Master's and I love golf, wasn't in my cup of tea. Hospital layout was a bit more old-fashion on walk-through and a few unfriendly faces on the tour really caught my attention

Still would be very happy going here! A great opportunity


7) MI -- Wayne State University Detroit Receiving Hospital
I really wanted to go to an academic center, but I just loved the nitty gritty nature of the ED here and the history of the program along with its university affiliation. I swear I could have had this as high as my #3 I enjoyed it, but the other places had a sense of adventure I didn't feel as much here. The most fun and cohesive residents on the interview trail and would be a blast to go out after shifts with them. Attendings even would go out too!

Cons: Didn't want to live in Detroit, not just because its not a great city (midtown and downtown are bumping with culture and sports) but the weather and roads/airport accessibility for the city weren't ideal for me on my short trip


8) MI -- Henry Ford Hospital
Paired this one up for when I was in town for the Receiving interview. I liked the facility and resources, but the graded responsibility wasn't for me.
I'd still be happy going here, but I had the decline in interest


Rejected by:
Cincinatti, Indiana, UNC, Regions St Paul and Hennepin

 

[surely]

Submitted anonymously via Google Form.

Step 1: 230s , Step 2: 250s
EM rotation grades: Honors / Honors
Inducted into Alpha Omega Alpha: No
Medical school region: West coast
Anything else that made you more competitive?: Great SLOES, strong leadership activities (national positions), jobs before medicine

Main Considerations in Creating this ROL:
Strong training with name brand recognition and networking since I'm considering health policy/admin/academics (I know, I know, I drank the kool aid). Also wellness and ability to do stuff outside of EM clinical duties. After that, California since family and friends are here, with some programs outside in special cases. (great training + I like the city). Don't care too much 3 vs 4 years - I figure residency training is important to the foundation of my career, and another year isn't going to make or break me. Don't know if I 'd want to do fellowship afterwards anyway. I liked what 4 year programs had to offer and Fresno put it best - let's stop having delayed gratification and actually start living during residency. I like programs that give a bit more time to breathe and explore, which I felt four year programs did.

1) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Strong program with great mix of academic and county, good amount of electives. More affordable to live in than SF. Got along with faculty and residents, partner would be happy to live and work here. Strong social medicine program, would support my policy and academic interests. Is about the EM training AND more. The additional 5k post tax for housing is a HUGE plus too. Huge wellness factor here. I appreciated them. Locums flying with peds helicopters? yes!


2) CA -- University of California San Francisco - San Francisco General Hospital
It's UCSF. Love the city, great mix of county and academic again. Favorite residents on the trail, had some funny interactions with the interviewing faculty but I had been warned about that. Great off service rotations. Amazing networking opportunities.


3) CA -- Los Angeles County - Harbor-UCLA Medical Center
Partner had preference for SoCal and LA in particular. Great county program with academic bent, more wellness oriented. Had a hard time deciding between 3-5 though, so honestly any of these next three could have been in any order. Wanted to switch them around again with 1 minute to go but was afraid of not getting certified. Big con I really had to consider was that they pay 10K less than LAC which stings. Also wish it was 12 hour shifts with more days off, but I can live with the schedule they have here. Having Admin/Jeopardy time really shows their commitment to wellness and taking care of their residents. Do have concerns about funding meetings and whatnot, and not funding international electives does suck :[


4) CA -- Los Angeles County/University of Southern California Medical Center
What can I say. It's LAC. I was so dang inspired on their interview day, and LOVED their didactics. Unparalleled. Love what they do for third year. Ranked below Harbor because still some concern about working so much, residents seemed more tired of all the LA programs. Love the alumni network and the great things they are doing in LA. Love the patient population. Seriously this place was top of my list for a long while though. Prefer 12 hour shifts to get more days off.


5) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
I really really really loved the interview day and loved the faculty/program. Didn't super click with the residents though and it felt a little more stuffy. Had concerns about living in basically suburbia at big city prices, which kinda hurt. Have full confidence that with the switch to four years, the program has seriously put thought into making true value of that fourth year and I can see this program only getting stronger. Ultimately put #3 and #4 above this program because partner wanted to live in LA more than here. Have faculty at my home program that graduated from here and they are one of my most favorite people in the ED - if they could come out of residency that way, I'd love to go there! Also huge focus on wellness here. I LOVED the PD here - probably my favorite PD on the trail.


6) OH -- University of Cincinnati College of Medicine
My only Non-California program for a reason. Actually do like Cinci as a city - bigger city with small town feel that I love. The program itself is PHENOMENAL and I 100% wanted to go there. Only issues is that it is very much lacking in minorities (which can be tough - it does help to have at least some people who look like you) AND I wouldn't have family around here. Also, being California born and raised, it's a big daunting moving out of state. But, Cinci has such amazing EMS training and the committment to the department by the whole institution is amazing. The fact that the department chair took time to memorize something about each of us applicants and took me aside to promise to support my specific passions was incredible. They blew me out of the water. I wanted to rank them higher but Partner was also hesitant to leave their family here in Cali.


7) CA -- University of California San Francisco/ Fresno
Another one of those programs with PHENOMENAL training with incredible faculty/residents...BUT it's fresno. And I hate to say it, but partner and I felt like since we are young and have no kids or other attachments yet, we wanted to be in a larger city during residency to enjoy what a larger city has. We figured we aren't going to be amassing wealth while I'm in residency so may as well be somewhere where there are always fun and cheap things going on. Otherwise, fresno's training is unparalleled, IMO. So many procedures, such command of the ED, great pathology, great connection with the US park forest service.


8) CA -- Loma Linda University School of Medicine
Strong 3 year program near family. Faculty from programs such as Stanford and Fresno, into wellness, huge catchment area with a good amount of trauma. Of the inland empire, is the oldest program and most well respected, traumas go to them since they are the major level 1. Would be supportive of my passions.


9) CA -- Alameda Health System - Highland Hospital
Ranked this below Loma Linda because partner would rather live in Loma Linda than Oakland. Made me sad, but since I've gotten to pick a lot of this list, let them have this one. Cost of living is quite high here, and four years here was tough to sell. Program was nice enough, although somehow just didn't jive with the crowd that much. Still super strong program and would be happy to train here (although let's be honest, feel like I was a sympathy invite and I probably wouldn't match there if it was my #1 - they barely go down their list to match people).


10) CA -- University of California Irvine Medical Center
Had a hard time also figuring out where this goes. Like the area, but concerns about how tired the residents felt and how small the program was - would make it hard to switch shifts when you need to. However, did like the intensity of the PD and the faculty there, enjoyed where their heads were at. Just I had other great programs that I gravitated to and this ended up here. Would still be absolutely 100% happy to match here.


11) CA -- Riverside Community Hospital / University of California Riverside
Great PD, and awesome residents. I seriously liked the folks here. Just concerned about how there was only 1 female faculty I met all day and most everyone I met there was male. Also I wanted a little more of an alumni network just based on what I want to do. Great focus on resident wellness though.


12) CA -- Kaiser Permanente San Diego Medical Center
Wanted to see what a fully community program was like. Honestly was impressed with the faculty there (trained at Denver, Jacobi, etc) and they were frank and inviting. Would be happy to train here as well, just that I had other great programs and wanted more academic and county (didn't really fully figure that out until more into the season). Also the residents seemed almost TOO chill (as per my partner). I'd probably stick out like a sore thumb there, TBH.



Anything else to add?
Overall, WOW this season showed me how much SLOES and EC's can really tip the scales. I definitely applied to too many programs, but was under the impression that since my step 1 score was average and I didn't know how I had done on my SLOES, I should apply to the average. Couple that with my application being California heavy and I had some concerns since it is competitive in Cali. I had 2 SLOES/LoR from California and then one midwest and one east coast, so helped me get invites all over. I should have done more research when applying but I really just chose big cities and west coast and did scatter shot applying. I made sure to decline so I didn't go to more than 12 but I could have definitely saved myself money by applying to less. I am definitely more happy with the top 2/3 of my list and I chose to go to them intentionally, the other ones were more convenient for me to travel to and I would be happy to go to them as well. Ultimately chose my interviews due to ease of access (my lazy and cheap self shone through).

Applied to:
See List and Below + UC Davis (who ghosted me)

Withdrew from before hearing anything:
University of Chicago, Cook County, Harvard Mass General, Kern County, Kaweah Delta Health Care, Advocate Christ, Cleveland Metrohealth, Desert Regional, Florida Hospital Medical Center, Maimonides, Orlando Health

Rejected by:
Harvard/Beth Israel,Univ New Mexico, Mt Sinai Ichan, Vanderbilt

Invited to interview, but declined:
George Washington, John Hopkins, Georgetown, OHSU, Ohio State, Mt Sinai St Lukes, University of Washington, Wright State, University of Chicago Illinois, Boston University, Rush, University of Cleveland, UT Austin, Presence Resurrection, NYU, Denver Health, UC San Diego